Search results for: delivery status

Authors: Ayesha Akbar

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Pakistan is moving from a security state to a welfare state despite several security challenges both internal and external. Human security signifies a varied approach in different regions depending upon the leadership and policy priorities. The link between human development and economic growth is not automatic. It has to be created consciously by forward-looking policies and strategies by national governments. There are seven components or categories of human security these include: Economic Security, Personal Security, Health Security, Environmental Security, Food Security, Community Security and Political Security. The increasing interest of the international community to clearly understand the dimensions of human security provided the grounds to Pakistani scholars as well to ponder on the issue and delineate lines of human security. A great deal of work has been either done or in process to evaluate human security indicators in Pakistan. Notwithstanding, after having been done a great deal of work the human security in Pakistan is not satisfactory. A range of deteriorating indicators of human development that lies under the domain of human security leaves certain inquiries to be answered. What are the dimensions of human security in Pakistan? And how are they being dealt from the perspective of policy and institution in terms of its operationalization in Pakistan? Is the human security discourse reflects evidence-based policy changes. The methodology is broadly based on qualitative methods that include interviews, content analysis of policy documents. Pakistan is among the most populous countries in the world and faces high vulnerability to climate change. Literacy rate has gone down with the surge of youth bulge to accommodate in the job market. Increasing population is creating food problems as the resources have not been able to compete with the raising demands of food and other social amenities of life. Majority of the people are facing acute poverty. Health outcomes are also not satisfactory with the high infant and maternal mortality rate. Pakistan is on the verge of facing water crisis as the water resources are depleting so fast with the high demand in agriculture and energy sector. Pakistan is striving hard to deal with the declining state of human security but the dilemma is lack of resources that hinders in meeting up with the emerging demands. The government requires to bring about more change with scaling-up economic growth avenues with enhancing the capacity of human resources. A modern performance drive culture with the integration of technology is required to deliver efficient and effective service delivery. On an already fast track process of reforms; e-governance and evidence based policy mechanism is being instilled in the government process for better governance and evidence based decisions.

Keywords: governance, human development index, human security, Pakistan, policy

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Authors: Farah Naja, Mohamad Alameddine

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Background: The difficulty of compliance to therapeutic and lifestyle management of type 2 diabetes mellitus (T2DM) encourages patients to use complementary and alternative medicine (CAM) therapies. Little is known about the prevalence and mode of CAM use among diabetics in the Eastern Mediterranean Region in general and Lebanon in particular. Objective: To assess the prevalence and modes of CAM use among patients with T2DM residing in Beirut, Lebanon. Methods: A cross-sectional survey of T2DM patients was conducted on patients recruited from two major referral centers - a public hospital and a private academic medical center in Beirut. In a face-to-face interview, participants completed a survey questionnaire comprised of three sections: socio-demographic, diabetes characteristics and types and modes of CAM use. Descriptive statistics, univariate and multivariate logistic regression analyses were utilized to assess the prevalence, mode and correlates of CAM use in the study population. The main outcome in this study (CAM use) was defined as using CAM at least once since diagnosis with T2DM. Results: A total of 333 T2DM patients completed the survey (response rate: 94.6%). Prevalence of CAM use in the study population was 38%, 95% CI (33.1-43.5). After adjustment, CAM use was significantly associated with a “married” status, a longer duration of T2DM, the presence of disease complications, and a positive family history of the disease. Folk foods and herbs were the most commonly used CAM followed by natural health products. One in five patients used CAM as an alternative to conventional treatment. Only 7 % of CAM users disclosed the CAM use to their treating physician. Health care practitioners were the least cited (7%) as influencing the choice of CAM among users. Conclusion: The use of CAM therapies among T2DM patients in Lebanon is prevalent. Decision makers and care providers must fully understand the potential risks and benefits of CAM therapies to appropriately advise their patients. Attention must be dedicated to educating T2DM patients on the importance of disclosing CAM use to their physicians especially patients with a family history of diabetes, and those using conventional therapy for a long time.

Keywords: nutritional supplements, type 2 diabetes mellitus, complementary and alternative medicine (CAM), conventional therapy

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Authors: C. Shekhar Parajulee

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Nepal practiced a centralized unitary governing system for a long and has gone through the federal system after the promulgation of the new constitution on 20 September 2015. There is a big paradigm shift in terms of governance after it. Now, there are three levels of governments, one federal government in the center, seven provincial governments and 753 local governments. Federalism refers to a political governing system with multiple tiers of government working together with coordination. It is preferred for self and shared rule. Though it has opened the door for rights of the people, political stability, state restructuring, and sustainable peace and development, there are many prospects and challenges for its proper implementation. This research analyzes the discourses of federalism implementation in Nepal with special reference to one of seven provinces, Gandaki. Federalism is a new phenomenon in Nepali politics and informed debates on it are required for its right evolution. This research will add value in this regard. Moreover, tracking its evolution and the exploration of the attitudes and behaviors of key actors and stakeholders in a new experiment of a new governing system is also important. The administrative and political system of Gandaki province in terms of service delivery and development will critically be examined. Besides demonstrating the performances of the provincial government and assembly, it will analyze the inter-governmental relation of Gandaki with the other two tiers of government. For this research, people from provincial and local governments (elected representatives and government employees), provincial assembly members, academicians, civil society leaders and journalists are being interviewed. The interview findings will be analyzed by supplementing with published documents. Just going into the federal structure is not the solution. As in the case of other provincial governments, Gandaki had also to start from scratch. It gradually took a shape of government and has been functioning sluggishly. The provincial government has many challenges ahead, which has badly hindered its plans and actions. Additionally, fundamental laws, infrastructures and human resources are found to be insufficient at the sub-national level. Lack of clarity in the jurisdiction is another main challenge. The Nepali Constitution assumes cooperation, coexistence and coordination as the fundamental principles of federalism which, unfortunately, appear to be lacking among the three tiers of government despite their efforts. Though the devolution of power to sub-national governments is essential for the successful implementation of federalism, it has apparently been delayed due to the centralized mentality of bureaucracy as well as a political leader. This research will highlight the reasons for the delay in the implementation of federalism. There might be multiple underlying reasons for the slow pace of implementation of federalism and identifying them is very tough. Moreover, the federal spirit is found to be absent in the main players of today's political system, which is a big irony. So, there are some doubts about whether the federal system in Nepal is just a keepsake or a substantive.

Keywords: federalism, inter-governmental relations, Nepal, provincial government

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Authors: Arojojoye Oluwatosin Adetola, Nwaechefu Olajumoke Olufunlayo, Ademola Adetokunbo Oyagbemi, Jeremiah Moyinoluwalogo Afolabi, Asaolu Racheal Oluwabukola

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The effects of man’s activities on the environment include depletion of natural resources alongside pollution of water bodies. Petroleum exploration in the Niger Delta region of Nigeria has compromised the aquatic environment with grave consequences on the entire ecosystem. In this study, we assessed the environmental safety of Araromi River, located in an oil-producing area in Ondo State, in the Niger Delta region of Nigeria by determining the levels of heavy metals (copper, cadmium, chromium, nickel, lead) and some biomarkers of oxidative stress (malondialdehyde, glutathione-S-transferase, glutathione peroxidase, catalase, superoxide dismutase, myeloperoxidase and reduced glutathione) in Clarias gariepinus (350-400g) from the river using standard methods. Clarias gariepinus from a clean fish farm in the same geographical location as the reference site (Ilesannmi fishery) was used as a control. Water samples from both sites were also analysed for some physicochemical parameters, heavy metals, and bacterial contamination. Our findings show a significant increase in malondialdehyde level (index of lipid peroxidation) as well as alterations in antioxidant status in the organs of Clarias gariepinus from Araromi River compared with control. A significant increase in bacterial contaminants, heavy metal pollutants, and particulate matter deposits were also observed in the water sample from Araromi River compared with control. In conclusion, high levels of indicators of environmental pollution observed in the water sample from Araromi River coupled with induction of oxidative stress in Clarias gariepinus from the river show that Araromi River is polluted; therefore, consumption of fishes and other aquatic organisms from the river may be unsafe for the people in that community.

Keywords: Araromi River, Clarias gariepinus, environmental pollution, heavy metals, oxidative stress

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Authors: Ntandoni Gloria Biyela

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During traditional times, there were no formal institutions of learning as they are today, where children attend classes to acquire or develop knowledge. This does not mean that there was no learning in indigenous African societies. Grandparents used to tell their grandchildren stories or teach them educational games around the fireplace, which this study refers to as a ‘traditional classroom’. A story recreated in symbolic or allegorical way, forms a base for a society’s beliefs, customs, accepted norms and language learning. Through folklore narratives, a society develops its own self awareness and education. So narrative characters, especially animals may be mythical products of the pre-literate folklore world and thus show the closeness that the Zulu society had with the wildlife. Oral cultures strive to create new facets of meaning by the use of animal metaphors to reflect the relationship of humans with the animal realm and to contribute to the language learning or literature in cross-cultural studies. Although animal metaphors are widespread in Zulu language because of the Zulu nation’s traditional closeness to wildlife, little field-research has been conducted on the social behavior of animals on the way in which their characteristics were transferred with precision to depictions of King Shaka’s behavior and activities during the amalgamation of Nguni clans into a Zulu kingdom. This study attempts to fill the gap by using first-hand interviews with local informants in areas traditionally linked to the king in KwaZulu-Natal province, South Africa. Departing from the conceptual metaphor theory, the study concentrates on King Shaka’s praise-poems in which the praise-poet describes his physical and dispositional characteristics through bold animal metaphors of the ‘Big Five’; namely, the lion, the leopard, the buffalo, the rhinoceros and the elephant, which are often referred to as Zulu royal favorites. These metaphors are still learnt by young and old in the 21st century because they reflect the responsibilities, status, and integrity of the king and the respect in which he is held by his people. They also project the crescendo growth of the Zulu nation, which, through the fulfillment of his ambitions, grew from a small clan to a mighty kingdom.

Keywords: animal, indigenous, learning, metaphor

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Authors: Adesola Odole, Nse Odunaiya, Samuel Adewale

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Chronic Mechanical Low Back Pain (CMLBP) is prevalent in the aging population; some studies have documented the association among pain intensity, functional disability and physical activity in the general population but very few studies in the elderly. This study was designed to investigate the association among pain intensity, functional disability and physical activity of elderly individuals with CMLBP in the University College Hospital (UCH), Ibadan, Nigeria and also to determine the difference in physical activity, pain intensity and functional disability between males and females. A total of 96 participants diagnosed with CMLBP participated in this cross-sectional survey. They were conveniently sampled from selected units in the UCH, Ibadan, Nigeria. Data on sex, marital status, occupation and duration of onset of pain of participants were obtained from the participants. The Physical Activity Scale for the Elderly, Visual Analogue Scale and Oswestry Disability Questionnaire were used to measure the physical activity, pain intensity and functional disability of the participants respectively. Data was analysed using Spearman correlation, independent t-test; and α was set at 0.05. Participants (25 males, 71 females) were aged 69.64±7.43 years. The majority (76.0%) of the participants were married, and over half (55.2%) were retirees. Participants’ mean pain intensity score was 5.21±2.03 and mean duration of onset of low back pain was 63.63 ± 90.01 months. The majority (67.6%) of the participants reported severe to crippled functional disability. Their mean functional disability was 46.91 ± 13.99. Participants’ mean physical activity score was 97.47 ± 82.55. There was significant association between physical activity and pain intensity (r = -0.21, p = 0.04). There was significant association between physical activity and functional disability (r = -0.47, p = 0.00). Male (87.26 ± 79.94) and female (101.07 ± 83.71) participants did not differ significantly in physical activity (t = 0.00, p = 0.48). In addition, male (5.48 ± 2.06) and female (5.11 ± 2.02) participants’ pain intensity were comparable (t = 0.26, p = 0.44). There was also no significant difference in functional disability (t = 0.05, p = 0.07) between male (42.56 ±13.85) and female (48.45 ± 13.81) participants. It can be concluded from this study that majority of the elderly individuals with chronic mechanical low back pain had a severe to crippled functional disability. Those who reported increased physical activity had reduced pain intensity and functional disability. Male and female elderly individuals with chronic mechanical low back pain are comparable in their pain intensity, functional disability, and physical activity. Elderly individuals with CMLBP should be educated on the importance of participating in physical activity which could reduce their pain symptoms and improve functional disability.

Keywords: elderly, functional disability, mechanical low back pain, pain intensity, physical activity

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Authors: Laith F. Gulli, Nicole M. Mallory

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We developed a novel measurement instrument to assess Knowledge of Educational Programs in Professional Psychotherapy Programs (KEP-PPP or KEP-Triple P) within the United States. The instrument was designed by a Panel of Experts (PoE) that consisted of Licensed Psychotherapists and Medical Care Providers. Licensure track psychotherapy programs are listed in the databases of the Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE); American Psychological Association (APA); Council on Social Work Education (CSWE); and the Council for Accreditation of Counseling & Related Educational Programs (CACREP). A complete list of psychotherapy programs can be obtained from these professional databases, selecting search fields of (All Programs) in (All States). Each program has a Web link that electronically and directly connects to the institutional program, which can be researched using the KEP-Triple P. The 29-item KEP Triple P was designed to consist of six categorical fields; Institutional Type: Degree: Educational Delivery: Accreditation: Coursework Competency: and Special Program Considerations. The KEP-Triple P was designed to determine whether a specific course(s) is offered in licensure track psychotherapy programs. The KEP-Triple P is designed to be modified to assess any part or the entire curriculum of licensure graduate programs. We utilized the KEP-Triple P instrument to study whether a graduate course in Addictions was offered in Marriage and Family Therapy (MFT) programs. Marriage and Family Therapists are likely to commonly encounter patients with Addiction(s) due to the broad treatment scope providing psychotherapy services to individuals, couples and families of all age groups. Our study of 124 MFT programs which concluded at the end of 2016 found that we were able to assess 61 % of programs (N = 76) since 27 % (N = 34) of programs were inaccessible due to broken Web links. From the total of all MFT programs 11 % (N = 14) did not have a published curriculum on their Institutional Web site. From the sample study, we found that 66 % (N = 50) of curricula did not offer a course in Addiction Treatment and that 34 % (N =26) of curricula did require a mandatory course in Addiction Treatment. From our study sample, we determined that 15 % (N = 11) of MFT doctorate programs did not require an Addictions Treatment course and that 1 % (N = 1) did require such a course. We found that 99 % of our study sample offered a Campus based program and 1 % offered a hybrid program with both online and residential components. From the total sample studied, we determined that 84 % of programs would be able to obtain reaccreditation within a five-year period. We recommend that MFT programs initiate procedures to revise curricula to include a required course in Addiction Treatment prior to their next accreditation cycle, to improve the escalating addiction crisis in the United States. This disparity in MFT curricula raises serious ethical and legal consideration for national and Federal stakeholders as well as for patients seeking a competently trained psychotherapist.

Keywords: addiction, competency, curriculum, psychotherapy

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Authors: Pariya Sheykhmaleki, Debajyoti Pati

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Rural areas in the United States face numerous challenges in providing quality and assessable primary healthcare services, especially during emergencies such as natural disasters or pandemics. This study showcases a cutting-edge flexible module that aims to overcome these challenges by offering adaptable healthcare facilities capable of providing comprehensive health services in remote and disaster-prone regions. According to the Health Resources and Services Administration (HRSA), approximately 62 million Americans, or 1 in 5 individuals, live in areas designated as Health Professional Shortage Areas (HPSAs) for primary care. These areas are characterized by limited access to healthcare facilities, shortage of healthcare professionals, transportation barriers, inadequate healthcare infrastructure, higher rates of chronic diseases, mental health disparities, and limited availability of specialized care, including urgent circumstances like pandemics that can exacerbate this issue. To address these challenges, the literature study began by examining primary health solutions in very remote areas, e.g., spaceships, to identify the state-of-the-art technologies and the methods used to facilitate primary care needs. The literature study on flexibility in architecture and interior design was also adapted to develop a conceptual design for rural areas. The designed flexible module provides an innovative solution. This module can be prefabricated as all parts are standardized. The flexibility of the module allows the structure to be modified based on local and geographical requirements as well as the ability to expand as required. It has been designed to stand either by itself or work in tandem with public buildings. By utilizing sustainable approaches and flexible spatial configurations, the module optimizes the utilization of limited resources while ensuring efficient and effective healthcare delivery. Furthermore, the poster highlights the key features of this flexible module, including its ability to support telemedicine and telehealth services for all five levels of urgent care conditions, i.e., from facilitating fast tracks to supporting emergency room services, in two divided zones. The module's versatility enables its deployment in rural areas located far from urban centers and disaster-stricken regions, ensuring access to critical healthcare services in times of need. This module is also capable of responding in urban areas when the need for primary health becomes vastly urgent, e.g., during a pandemic. It emphasizes the module's potential to bridge the healthcare gap between rural and urban areas and mitigate the impact of rural health challenges.

Keywords: rural health, healthcare challenges, flexible modular design, telemedicine, telehealth

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Authors: Jae-Yong Park, Yeo-Kyeong Lee, Hee-Sun Kim

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Purpose: This study aims at investigating the mechanical behaviors of mastication, according to various teeth movement. There are three masticatory cases which are general case and 2 cases of teeth movement. General case includes the common arrange of all teeth and 2 cases of teeth movement are that one is the half movement location case of molar teeth in no. 14 tooth seat after extraction of no. 14 tooth and the other is no. 14 tooth seat location case of molar teeth after extraction in the same case before. Materials and Methods: In order to analyze these cases, 3 dimensional finite element (FE) model of the skull were generated based on computed tomography images, 964 dicom files of 38 year old male having normal occlusion status. An FE model in general occlusal case was used to develop CAE procedure. This procedure was applied to FE models in other occlusal cases. The displacement controls according to loading condition were applied effectively to simulate occlusal behaviors in all cases. From the FE analyses, von Mises stress distribution of skull and teeth was observed. The von Mises stress, effective stress, had been widely used to determine the absolute stress value, regardless of stress direction and yield characteristics of materials. Results: High stress was distributed over the periodontal area of mandible under molar teeth when the mandible was transmitted to the coronal-apical direction in the general occlusal case. According to the stress propagation from teeth to cranium, stress distribution decreased as the distribution propagated from molar teeth to infratemporal crest of the greater wing of the sphenoid bone and lateral pterygoid plate in general case. In 2 cases of teeth movement, there were observed that high stresses were distributed over the periodontal area of mandible under teeth where they are located under the moved molar teeth in cranium. Conclusion: The predictions of the mechanical behaviors of general case and 2 cases of teeth movement during the masticatory process were investigated including qualitative validation. The displacement controls as the loading condition were applied effectively to simulate occlusal behaviors in 2 cases of teeth movement of molar teeth.

Keywords: cranium, finite element analysis, mandible, masticatory action, occlusal force

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Authors: Zhaojun Wang, Zongdi Sun, Qinqin Cui, Xingwan Ren

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Based on multivariate statistical analysis theory, this paper uses the principal component analysis method, Mahalanobis distance analysis method and fitting method to establish the photovoltaic health model to evaluate the health of photovoltaic panels. First of all, according to weather conditions, the photovoltaic panel variable data are classified into five categories: sunny, cloudy, rainy, foggy, overcast. The health of photovoltaic panels in these five types of weather is studied. Secondly, a scatterplot of the relationship between the amount of electricity produced by each kind of weather and other variables was plotted. It was found that the amount of electricity generated by photovoltaic panels has a significant nonlinear relationship with time. The fitting method was used to fit the relationship between the amount of weather generated and the time, and the nonlinear equation was obtained. Then, using the principal component analysis method to analyze the independent variables under five kinds of weather conditions, according to the Kaiser-Meyer-Olkin test, it was found that three types of weather such as overcast, foggy, and sunny meet the conditions for factor analysis, while cloudy and rainy weather do not satisfy the conditions for factor analysis. Therefore, through the principal component analysis method, the main components of overcast weather are temperature, AQI, and pm2.5. The main component of foggy weather is temperature, and the main components of sunny weather are temperature, AQI, and pm2.5. Cloudy and rainy weather require analysis of all of their variables, namely temperature, AQI, pm2.5, solar radiation intensity and time. Finally, taking the variable values in sunny weather as observed values, taking the main components of cloudy, foggy, overcast and rainy weather as sample data, the Mahalanobis distances between observed value and these sample values are obtained. A comparative analysis was carried out to compare the degree of deviation of the Mahalanobis distance to determine the health of the photovoltaic panels under different weather conditions. It was found that the weather conditions in which the Mahalanobis distance fluctuations ranged from small to large were: foggy, cloudy, overcast and rainy.

Keywords: fitting, principal component analysis, Mahalanobis distance, SPSS, MATLAB

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Authors: Medani Prasad Rijal

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Forest itself is a factory as well as product. It supplies tangible and intangible goods and services. It supplies timber, fuel wood, fodder, grass leaf litter as well as non timber edible goods and medicinal and aromatic products additionally provides environmental services. These environmental services are of local, national or even global importance. In Nepal, more than 19 thousands community forests are providing environmental service in less economic benefit than actual efficiency. There is a risk of cost of management of those forest exceeds benefits and forests get converted to open access resources in future. Most of the environmental goods and services do not have markets which mean no prices at which they are available to the consumers, therefore the valuation of these services goods and services establishment of paying mechanism for such services and insure the benefit to community is more relevant in local as well as global scale. There are few examples of carbon trading in domestic level to meet the country wide emission goal. In this contest, the study aims to explore the public attitude towards carbon offsetting and their responsibility over service providers. This study helps in promotion of environment service awareness among general people, service provider and community forest. The research helps to unveil the carbon pool scenario in community forest and willingness to pay for carbon offsetting of people who are consuming more energy than general people and emitting relatively more carbon in atmosphere. The study has assessed the carbon pool status in two community forest and valuated carbon service from community forest through willingness to pay in Dharan municipality situated in eastern. In the study, in two community forests carbon pools were assessed following the guideline “Forest Carbon Inventory Guideline 2010” prescribed by Ministry of Forest and soil Conservation, Nepal. Final outcomes of analysis in intensively managed area of Hokse CF recorded as 103.58 tons C /ha with 6173.30 tons carbon stock. Similarly in Hariyali CF carbon density was recorded 251.72 mg C /ha. The total carbon stock of intensively managed blocks in Hariyali CF is 35839.62 tons carbon.

Keywords: carbon, offsetting, sequestration, valuation, willingness to pay

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Authors: Mohammad Anwarul Kabir, Fayezul Islam

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Language invariably is learned / taught to be used primarily as means of communications. Teaching a language for its native audience differs from teaching it to non-native audience. Moreover, teaching a language for communication only is different from teaching it for specific purposes. Arabic language is primarily regarded as the language of the Quran and the Sunnah (Prophetic tradition). Arabic is, therefore, learnt and spread all over the globe. However, Arabic is also a cultural heritage shared by all Islamic nations which has used Arabic for a long period to record the contributions of Muslim thinkers made in the field of wide spectrum of knowledge and scholarship. That is why the phenomenon of teaching Arabic by different educational institutes became quite rife, and the idea of teaching Arabic for specific purposes is heavily discussed in the academic sphere. Although the number of learners of Arabic is increasing consistently, yet their purposes vary. These include religious purpose, international trade, diplomatic purpose, better livelihood in the Arab world extra. By virtue of this high demand for learning Arabic, numerous institutes have been established all over the world including Bangladesh. This paper aims at focusing on the current status of the language institutes which has been established for learning Arabic for specific purposes in Bangladesh including teaching methodology, curriculum, and teachers’ quality. Such curricula and using its materials resulted in a lot of problems. The least, it confused teachers and students as well. Islamic educationalists have been working hard to professionally meet the need. They are following a systematic approach of stating clear and achievable goals, building suitable content, and applying new technology to present these learning experiences and evaluate them. It also suggests a model for designing instructional systems that responds to the need of non-Arabic speaking Islamic communities and provide the knowledge needed in both linguistic and cultural aspects. It also puts forward a number of suggestions for the improvement of the teaching / learning Arabic for specific purposes in Bangladesh after a detailed investigation in the following areas: curriculum, teachers’ skills, method of teaching and assessment policy.

Keywords: communication, Quran, sunnah, educational institutes, specific purposes, curriculum, method of teaching

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Authors: Jae Ni Jang, Young Uk Kim

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

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

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Authors: Hanaa Sameen Ameen Bajilan

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Human rights should be protected and promoted without regard to race, ethnicity, religion, political philosophy, or sexual orientation, following our firm convictions. Thus, any infringement of these rights or disdain for; any use of violence against women undermines the principles and human values of equality and endangers the entire society, including its potential to live in peace and to make growth and development. This paper represents the condition of the new Iraqi women regarding issues such as the gender wage gap, education, health, and violence against women. The study aims to determine the impact of traditions and customs on the legal position of Iraqi women. First, it seeks to assess the effects of culture as a historical agency on the legal status of Iraqi women. Second, the influence of cultural developments in the later part of the twentieth century on Iraqi women's legal standing, and third, the importance of cultural variety as a progressive cultural component in women's legal position. Finally, the study highlights the representation of women in Iraq: Gender wage Gap, Women's liberation between culture and law, and the role of women within Iraqi society based on an Iraqi novel named (Orange Light) in Arabic: برتقالو ضو. in her book, the Iraqi writer Nadia Al-Abru succeeds in portraying the post-war society's devotion to the sexual, emotional and mental marginalization of women in terms of the value of attendance. Since the study of Iraqi women's literature in Arabic-English translation is a new avenue of research that contributes to all three areas, this investigation aims to establish critical lines of engagement between contemporary Iraqi women's literature in English translation and feminist translation conceptual frameworks, and this is accomplished by first focusing on why analyzing Iraqi women writers' novels in Arabic-English translation is a timeline of inquiry that contributes to existing and emerging knowledge fields concerning Iraqi women writers' contemporary critical contexts and scholarship on Arab women's literature in Arabic-English translation.

Keywords: women in İraq, equality, violence, gender wage gap, Nadia Al-Abru, (orange light), women's liberation, İraqi women's literature,

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Authors: Tarek Elnimr, Reda Morsy, Assem El Fert, Aziza Ismail

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Hepatitis is an inflammation of the liver. The condition can be self-limiting or can progress to fibrosis, cirrhosis or liver cancer. Disease caused by the hepatitis virus, the virus can cause hepatitis infection, ranging in severity from a mild illness lasting a few weeks to a serious, lifelong illness. A growing body of evidence indicates that many trace elements play important roles in a number of carcinogenic processes that proceed with various mechanisms. To examine the status of trace elements during the development of hepatic carcinoma, we determined the iron, copper, zinc and selenium levels in some biological samples of patients at different stages of viral hepatic disease. We observed significant changes in the iron, copper, zinc and selenium levels in the biological samples of patients hepatocellular carcinoma, relative to those of healthy controls. The mean hair, nail, RBC, serum and whole blood copper levels in patients with hepatitis virus were significantly higher than that of the control group. In contrast the mean iron, zinc, and selenium levels in patients having hepatitis virus were significantly lower than those of the control group. On the basis of this study, we identified the impact of natural supplements to improve the treatment of viral liver damage, using the level of some trace elements such as, iron, copper, zinc and selenium, which might serve as biomarkers for increases survival and reduces disease progression. Most of the elements revealed diverse and random distribution in the samples of the donor groups. The correlation study pointed out significant disparities in the mutual relationships among the trace elements in the patients and controls. Principal component analysis and cluster analysis of the element data manifested diverse apportionment of the selected elements in the scalp hair, nail and blood components of the patients compared with the healthy counterparts.

Keywords: hepatitis, hair, nail, blood components, trace element, nutrition therapy, multivariate analysis, correlation, ICP-MS

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Authors: Hanna Gulema, Meaza Demissie, Alemayehu Worku, Tesfaye Assebe Yadeta, Yemane Berhane

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Background: In patriarchal societies, female caregivers decide on food allocation within a family based on prevailing gender and age norms, which may lead to inequality that does not favor young adolescent girls. This study evaluated the effect of a community-based social norm intervention involving female caregivers in West Hararghe, Ethiopia. The intervention was engaging female caregivers along with other adult influential community members to deliberate and act on food allocation social norms in a process referred to as Social Analysis and Action (SAA). Method: We used data from a large quasi-experimental study to compare family eating practices between those who participated in the Social Analyses and Action intervention and those who did not. The respondents were female caregivers in households with young adolescent girls (ages 13 and 14 years). The study’s outcome was the practice of family eating together from the same dish. The difference in difference (DID) analysis with the Mixed effect logistic regression model was used to examine the effect of the intervention. Result: The results showed improved family eating practices in both groups, but the improvement was greater in the intervention group. The DID analysis showed an 11.99 percentage points greater improvement in the intervention arm than in the control arm. The mixed-effect regression produced an adjusted odds ratio of 2.08 (95% CI [1.06–4.09]) after controlling selected covariates, p-value 0.033. Conclusions: The involvement of influential adult community members significantly improves the family practice of eating together in households where adolescent girls are present in our study. The intervention has great potential to minimize household food allocation inequalities and thus improve the nutritional status of young adolescents. Further studies are necessary to evaluate the effectiveness of the intervention in different social norm contexts to formulate policy and guidelines for scale-up.

Keywords: family eating practice, social norm intervention, adolescence girls, caregiver

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Authors: Shahid Razzaq

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The governments around the globe have started taking into considerations the knowledge management dynamics while formulating, implementing, and evaluating the strategies, with or without the conscious realization, for the different public sector organizations and public policy developments. Health Department of Punjab province in Pakistan is striving to deliver quality healthcare services to the community through an efficient and effective service delivery system. Despite of this struggle some employee performance issues yet exists in the form of challenge to government. To overcome these issues department took several steps including HR strategies, use of technologies and focus of hard issues. Consequently, this study was attempted to highlight the importance of soft issue that is knowledge management in its true essence to tackle their performance issues. Knowledge management in public sector is quite an ignored area in the knowledge management-a growing multidisciplinary research discipline. Knowledge-based view of the firm theory asserts the knowledge is the most deliberate resource that can result in competitive advantage for an organization over the other competing organizations. In the context of our study it means for gaining employee performance, organizations have to increase the heterogeneous knowledge bases. The study uses the cross-sectional and quantitative research design. The data is collected from the knowledge workers of Health Department of Punjab, the biggest province of Pakistan. A total of 341 sample size is achieved. The SmartPLS 3 Version 2.6 is used for analyzing the data. The data examination revealed that knowledge management processes has a strong impact on knowledge worker performance. All hypotheses are accepted according to the results. Therefore, it can be summed up that to increase the employee performance knowledge management activities should be implemented. Health Department within province of Punjab introduces the knowledge management infrastructure and systems to make effective availability of knowledge for the service staff. This knowledge management infrastructure resulted in an increase in the knowledge management process in different remote hospitals, basic health units and care centers which resulted in greater service provisions to public. This study is to have theoretical and practical significances. In terms of theoretical contribution, this study is to establish the relationship between knowledge management and performance for the first time. In case of the practical contribution, this study is to give an insight to public sector organizations and government about role of knowledge management in employ performance. Therefore, public policymakers are strongly advised to implement the activities of knowledge management for enhancing the performance of knowledge workers. The current research validated the substantial role of knowledge management in persuading and creating employee arrogances and behavioral objectives. To the best of authors’ knowledge, this study contribute to the impact of knowledge management on employee performance as its originality.

Keywords: employee performance, knowledge management, public sector, soft issues

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Authors: Carmela Nardelli, Laura Iaffaldano, Valentina Capobianco, Antonietta Tafuto, Maddalena Ferrigno, Angela Capone, Giuseppe Maria Maruotti, Maddalena Raia, Rosa Di Noto, Luigi Del Vecchio, Pasquale Martinelli, Lucio Pastore, Lucia Sacchetti

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Maternal obesity and nutrient excess in utero increase the risk of future metabolic diseases in the adult life. The mechanisms underlying this process are probably based on genetic, epigenetic alterations and changes in foetal nutrient supply. In mammals, the placenta is the main interface between foetus and mother, it regulates intrauterine development, modulates adaptive responses to sub optimal in uterus conditions and it is also an important source of human amniotic mesenchymal stem cells (hA-MSCs). We previously highlighted a specific microRNA (miRNA) profiling in amnion from obese (Ob) pregnant women, here we compared the miRNA expression profile of hA-MSCs isolated from (Ob) and control (Co) women, aimed to search for any alterations in metabolic pathways that could predispose the new-born to the obese phenotype. Methods: We isolated, at delivery, hA-MSCs from amnion of 16 Ob- and 7 Co-women with pre-pregnancy body mass index (mean/SEM) 40.3/1.8 and 22.4/1.0 kg/m2, respectively. hA-MSCs were phenotyped by flow cytometry. Globally, 384 miRNAs were evaluated by the TaqMan Array Human MicroRNA Panel v 1.0 (Applied Biosystems). By the TargetScan program we selected the target genes of the miRNAs differently expressed in Ob- vs Co-hA-MSCs; further, by KEGG database, we selected the statistical significant biological pathways. Results: The immunophenotype characterization confirmed the mesenchymal origin of the isolated hA-MSCs. A large percentage of the tested miRNAs, about 61.4% (232/378), was expressed in hA-MSCs, whereas 38.6% (146/378) was not. Most of the expressed miRNAs (89.2%, 207/232) did not differ between Ob- and Co-hA-MSCs and were not further investigated. Conversely, 4.8% of miRNAs (11/232) was higher and 6.0% (14/232) was lower in Ob- vs Co-hA-MSCs. Interestingly, 7/232 miRNAs were obesity-specific, being expressed only in hA-MSCs isolated from obese women. Bioinformatics showed that these miRNAs significantly regulated (P<0.001) genes belonging to several metabolic pathways, i.e. MAPK signalling, actin cytoskeleton, focal adhesion, axon guidance, insulin signaling, etc. Conclusions: Our preliminary data highlight an altered miRNA profile in Ob- vs Co-hA-MSCs and suggest that an epigenetic miRNA-based mechanism of gene regulation could affect pathways involved in placental growth and function, thereby potentially increasing the newborn’s risk of metabolic diseases in the adult life.

Keywords: hA-MSCs, obesity, miRNA, biosystem

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Authors: George N. Prodromidis, Frank A. Coutelieris

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Biogas can be currently considered as an alternative option for electricity production, mainly due to its high energy content (hydrocarbon-rich source), its renewable status and its relatively low utilization cost. Solid Oxide Fuel Cell (SOFC) stacks convert fuel’s chemical energy to electricity with high efficiencies and reveal significant advantages on fuel flexibility combined with lower emissions rate, especially when utilize biogas. Electricity production by biogas constitutes a composite problem which incorporates an extensive parametric analysis on numerous dynamic variables. The main scope of the presented study is to propose a detailed thermodynamic model on the optimization of SOFC-based power plants’ operation based on fundamental thermodynamics, energy and exergy balances. This model named THERMAS (THERmodynamic MAthematical Simulation model) incorporates each individual process, during electricity production, mathematically simulated for different case studies that represent real life operational conditions. Also, THERMAS offers the opportunity to choose a great variety of different values for each operational parameter individually, thus allowing for studies within unexplored and experimentally impossible operational ranges. Finally, THERMAS innovatively incorporates a specific criterion concluded by the extensive energy analysis to identify the most optimal scenario per simulated system in exergy terms. Therefore, several dynamical parameters as well as several biogas mixture compositions have been taken into account, to cover all the possible incidents. Towards the optimization process in terms of an innovative OPF (OPtimization Factor), presented here, this research study reveals that systems supplied by low methane fuels can be comparable to these supplied by pure methane. To conclude, such an innovative simulation model indicates a perspective on the optimal design of a SOFC stack based system, in the direction of the commercialization of systems utilizing biogas.

Keywords: biogas, exergy, efficiency, optimization

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Authors: M. R. Bhuiyan, S. M. M. Hossain, M. Z. Islam

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Autism Spectrum Disorder (ASD) is the fastest growing serious developmental disorder characterized by social deficits, communicative difficulties, and repetitive behaviors. ASD is an emerging public health issue globally which is associated with huge financial burden to the family, community and the nation. The aim of this study was to assess the financial burden of family for the children with Autism spectrum Disorder. This cross-sectional study was carried out from July 2015 to June 2016 among 154 children with ASD to assess the financial burden of family. Data were collected by face-to-face interview with semi-structured questionnaire following systematic random sampling technique. Majority (73.4%) children were male and mean (±SD) age was 6.66 ± 2.97 years. Most (88.8%) of the children were from urban areas with average monthly family income Tk. 41785.71±23936.45. Average monthly direct cost of the children was Tk.17656.49 ± 9984.35, while indirect cost was Tk. 13462.90 ± 9713.54 and total treatment cost was Tk. 23076.62 ± 15341.09. Special education cost (Tk. 4871.00), cost of therapy (Tk. 4124.07) and travel cost (Tk. 3988.31) were the major types of direct cost, while loss of income (Tk.14570.18) was the chief indirect cost incurred by the families. The study found that majority (59.8%) of the children attended special schools were incurred Tk.20001-78700 as total treatment cost, which were statistically significant (p<0.001). Again, families with higher monthly family income incurred higher treatment cost (r=0.526, p<0.05). Difference between mean direct and indirect cost was found significant (t=4.190, df=61, p<0.001). According to the analysis of variance, mean difference of father’s educational status among direct cost (F=10.337, p<0.001) and total treatment cost (F=7.841, p<0.001), which were statistically significant. The study revealed that maximum children with ASD were under five years, three-fourth were male. According to monthly family income, maximum family were in middle class. The study recommends cost effective interventions and financial safety-net measures to reduce the financial burden of families for the children with ASD.

Keywords: autism spectrum disorder, financial burden, direct cost, indirect cost, special education

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Authors: Zeinab Farhat, Nicolas Errien, Romuald Wernert, Véronique Verriele, Frédéric Amiard, Philippe Daniel

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Ovarian cancer, also known as the silent killer, is the fifth most common cancer among women worldwide, and its death rate is higher than that of other gynecological cancers. The low survival rate of women with high-grade serous ovarian carcinoma highlights the critical need for the development of new methods for early detection and diagnosis of the disease. The aim of this study was to evaluate if Raman spectroscopy combined with chemometric methods such as Principal Component Analysis (PCA) could differentiate between cancerous and normal tissues from different types of samples, such as paraffin embedding, chemical deparaffinized, formalin-fixed and fresh samples of the same normal and malignant ovarian tissue. The method was applied specifically to two critical spectral regions: the signature region (860-1000 〖cm〗^(-1)) and the high-frequency region (2800-3100 〖cm〗^(-1) ). The mean spectra of paraffin-embedded in normal and malignant tissues showed almost similar intensity. On the other hand, the mean spectra of normal and cancer tissues from chemical deparaffinized, formalin-fixed, and fresh samples show significant intensity differences. These spectral differences reflect variations in the molecular composition of the tissues, particularly lipids and proteins. PCA, which was applied to distinguish between cancer and normal tissues, was performed on whole spectra and on selected regions—the PCA score plot of paraffin-embedded shows considerable overlap between the two groups. However, the PCA score of chemicals deparaffinized, formalin-fixed, and fresh samples showed a good discrimination of tissue types. Our findings were validated by analyses of a set of samples whose status (normal and cancerous) was not previously known. The results of this study suggest that Raman Spectroscopy associated with PCA methods has the capacity to provide clinically significant differentiation between normal and cancerous ovarian tissues.

Keywords: Raman spectroscopy, ovarian cancer, signal processing, Principal Component Analysis, classification

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Authors: Fiza Azam, Sahar Zia, Fatima Nazir Ali, Aysha Hanif

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Health is a fundamental human right, and a healthy population is essential for the prosperity and sustainable development of any country. This research is aligned with United Nations' Goal 3: Good Health and Well-being. It aims to assess and rank key health indicators across selected South Asian countries. The study focuses on urban areas in these nations, drawing on data from the World Bank’s primary collection of relevant indicators and specific health determinants outlined by the World Health Organization (WHO). These determinants include the physical environment, income and social status, education, social support networks, and personal behavior. To evaluate disparities in urban health across the region, the Urban Health Index (UHI) developed by Georgia State University, USA, is employed, followed by a mapping technique including visualization through a choropleth map to identify the pattern of spatial variations in our key variables, such as socioeconomic indicators across the region. This index serves as a comparative tool to rank health outcomes, where higher UHI values indicate better health conditions. The findings reveal notable disparities across South Asia. Afghanistan, with the lowest UHI score of 0.0423, ranks first, indicating the least favorable urban health conditions. Pakistan follows with a UHI score of 0.1190. Bangladesh and India rank third and fourth with UHI scores of 0.3099 and 0.3250, respectively. The Maldives and Sri Lanka rank fifth and sixth, with UHI scores of 0.3432 and 0.3495. Bhutan is ranked seventh with a score of 0.4750. Nepal, with a UHI score of 0.5012, ranks eighth, indicating the best urban health conditions among the countries studied. The findings of this research are crucial for addressing health disparities, improving living conditions, and enhancing social well-being in the region. These insights can inform policy measures aimed at reducing inequalities and promoting sustainable urban health in South Asia.

Keywords: urban health index, health disparities, sustainable development, South Asia, World Health Organization, United Nations, living conditions, public health

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Authors: Joseph Shanks, Matthew Taylor, Foong Kiew Ooi, Chee Keong Chen

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Introduction: Evidences of relationship between bone, muscle and standard of competition among young British population is limited in literature. The current literature recognises the independent and synergistic effects of fat free and fat mass as the stimulus for osteogenesis. This study assessed the extent to which physical activity (PA) and standard of competition (CS) influences quantitative ultrasound (QUS) measurements of bone on a cross-sectional basis accounting for muscular strength and anthropometrics in British young males. Methods: Pre-screening grouped 66 males aged 18-25 years into controls (n=33) and district level athletes (DLAs) (n=33) as well as low (n=21), moderate (n=23) and high (n=22) physical activity categories (PACs). All participants underwent QUS measurements of bone (4 sites, i.e. dominant distal radius (DR), dominant mid-shaft tibia (DT), non-dominant distal radius (NR) and non-dominant mid-shaft tibia (NT)), isokinetic strength tests (dominant and non-dominant knee flexion and extension) and anthropometric measurements. Results: There were no significant differences between any of the groups with respect to QUS measurements of bone at all sites with regards to PACs or CS. Significant higher isokinetic strength values were observed in DLAs than controls (p < 0.05), and higher than low PACs (p < 0.05) at 60o.s-1 of concentric and eccentric measurements. No differences in subcutaneous fat thickness were found between all the groups (CS or PACs). Percentages of body fat were significantly higher (p < .05) in low than high PACs and CS groups. There were significant positive relationships between non dominant radial speed of sound and fat free mass at both DR (r=0.383, p=0.001) and NR (r=0.319, p=0.009) sites in all participants. Conclusion: The present study findings indicated that muscular strength and body fat are closely related to physical activity level and standard of competition. However, bone health status reflected by quantitative ultrasound (QUS) measurements of bone is not related to physical activity level and standard of competition in British young males.

Keywords: bone, muscular strength, physical activity, standard of competition

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Authors: Fatemeh Dehghan Khangahi, Hakan Gunes

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Transforming a public necessity into a commercial commodity becomes more and more evident as time goes on, and it is one of the issues of water shortage. Development projects of countries, consume the water and waterbeds in various forms, ignoring the concepts such as sustainability and the negative effects they place on the environment, pollute and change the ways of waterways. Throughout these processes, the water basins and all the vital environments sometimes can suffer damage to the irreparable level. In this context, the issue of Lake Urmia that is located in the North West of Iran left alone by drought, has been researched. The lake, which is on the list of UNESCO's biosphere reserves, is now exposed to the danger of desiccation. If the desiccation is fully realized, more than 5.000.000 people that they are living around the lake, will have to migrate as a result of negative living conditions. As a matter of fact, along with the recent years of increasing drought level, regional migrations have begun. In addition to migration issues, it is also necessary to specify the negative effects on human and all-round’s life that depend on the formation of salt storms, mixing of salt into the air and soil, which threaten human health seriously because the lake is salty. The main aim of this work is to raise national and international awareness of this problem, which is an environment and a human tragedy at the same time. This research has two basic questions: 1) In the case of Lake Urmia, what are environmental problems and how they have emerged and what is the role of governments? 2) What is the social consequence of this problem in relation to the first question? In response, after the literature search, having a comparative view of the situation of the Aral Sea and the Great Salt Lake (Utah, USA), which involved the two major international examples. The first, one is related to the terms of population and migration, the second is about biological properties. Then, data and status information that provided after 3 years area research has been evaluated. Towards the end, with the support of qualitative and quantitative methods, the study of social mobilization in the region has been carried out. An example of it is using the public space of TRAXTOR matches like a protests area.

Keywords: environment problems, water, social mobilization, Lake Urmia, migration

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Authors: Eleanor Nel

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Research output is an indicator of institutional performance (and quality), resulting in increased pressure on academic institutions to perform in the research arena. Research output is further utilised to obtain research funding. Resultantly, academic institutions face significant pressure from governing bodies to provide evidence on the return for research investments. Research output has thus become a substantial discourse within institutions, mainly due to the processes linked to evaluating research output and the associated allocation of research funding. This focus on research outputs often surpasses the development of robust, widely accepted tools to additionally measure research impact at institutions. A publication writing programme, for enhancing research output, was launched at a South African university in 2011. Significant amounts of time, money, and energy have since been invested in the programme. Although participants provided feedback after each session, no formal review was conducted to evaluate the research output directly associated with the programme. Concerns in higher education about training costs, learning results, and the effect on society have increased the focus on value for money and the need to improve training, research performance, and productivity. Furthermore, universities rely on efficient and reliable monitoring and evaluation systems, in addition to the need to demonstrate accountability. While publishing does not occur immediately, achieving a return on investment from the intervention is critical. A multi-method study, guided by the New World Kirkpatrick Model (NWKM), was conducted to determine the impact of the publication writing programme for the period of 2011 to 2018. Quantitative results indicated a total of 314 academics participating in 72 workshops over the study period. To better understand the quantitative results, an open-ended questionnaire and semi-structured interviews were conducted with nine participants from a particular faculty as a convenience sample. The purpose of the research was to collect information to develop a comprehensive framework for impact evaluation that could be used to enhance the current design and delivery of the programme. The qualitative findings highlighted the critical role of a multi-stakeholder strategy in strengthening support before, during, and after a publication writing programme to improve the impact and research outputs. Furthermore, monitoring on-the-job learning is critical to ingrain the new skills academics have learned during the writing workshops and to encourage them to be accountable and empowered. The NWKM additionally provided essential pointers on how to link the results more effectively from publication writing programmes to institutional strategic objectives to improve research performance and quality, as well as what should be included in a comprehensive evaluation framework.

Keywords: evaluation, framework, impact, research output

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Authors: Antonio Lopez-Villegas, Rafael Bautista-Mesa, Emilio Robles-Musso, Daniel Catalan-Matamoros, Cesar Leal-Costa

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Objectives: The purpose of this trial was to evaluate the burden borne by and the costs to informal caregivers of users with telemonitoring of pacemakers. Methods: This is a controlled, non-randomised clinical trial, with data collected from informal caregivers, five years after implantation of pacemakers. The Spanish version of the Survey on Disabilities, Personal Autonomy, and Dependency Situations was used to get information on clinical and social characteristics, levels of professionalism, duration and types of care, difficulties in providing care, health status, economic and job aspects, impact on the family or leisure due to informal caregiving for patients with pacemakers. Results: After five years of follow-up, 55 users with pacemakers finished the study. Of which, 50 were helped by a caregiver, 18 were included in the telemonitoring group (TM) and 32 in the conventional follow-up group (HM). Overall, females represented 96.0% of the informal caregivers (88.89% in TM and 100.0% in HM group). The mean ages were 63.17 ± 15.92 and 63.13 ± 14.56 years, respectively (p = 0.83) in the groups. The majority (88.0%) of the caregivers declared that they had to provide their services between 6 and 7 days per week (83.33% in TM group versus 90.63% in HM group), without significant differences between both groups. The costs related to care provided by the informal caregivers were 47.04% higher in the conventional follow-up group than in the TM group. Conclusions: The results of this trial confirm that there were no significant differences between the informal caregivers regarding to baseline characteristics, workload and time worked in both groups of follow-up. The costs incurred by the informal caregivers providing care for users with pacemakers included in telemonitoring group are significantly lower than those in the conventional follow-up group. Trial registration: ClinicalTrials.gov NCT02234245. Funding: The PONIENTE study, has been funded by the General Secretariat for Research, Development and Innovation, Regional Government of Andalusia (Spain), project reference number PI/0256/2017, under the research call 'Development and Innovation Projects in the Field of Biomedicine and Health Sciences', 2017.

Keywords: costs, disease burden, informal caregiving, pacemaker follow-up, remote monitoring, telemedicine

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Authors: B. Sayaheen

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The translator’s competence is one of the topics that has received a great deal of research in the field of translation studies because such competencies are still debatable and not yet agreed upon. Besides, scholars tackle this topic from different points of view. Approaches to teaching these competencies have gone through some developments. This paper aims at investigating these developments, exploring the major turning points and shifts in the developments of teaching methods in translator training. The significance of these turning points and the external or internal causes will also be discussed. Based on the past and present status of teaching approaches in translator training, this paper tries to predict the future of these approaches. This paper is mainly concerned with developments of teaching approaches in the West since the 1980s to the present. The reason behind choosing this specific period is not because translator training started in the 1980s but because most criticism of the teacher-centered approach started at that time. The implications of this research stem from the fact that it identifies the turning points and the causes that led teachers to adopt student-centered approaches rather than teacher-centered approaches and then to incorporate technology and the Internet in translator training. These reasons were classified as external or internal reasons. Translation programs in the West and in other cultures can benefit from this study. Translation programs in the West can notice that teaching translation is geared toward incorporating more technologies. If these programs already use technology and the Internet to teach translation, they might benefit from the assumed future direction of teaching translation. On the other hand, some non-Western countries, and to be specific some professors, are still applying the teacher-centered approach. Moreover, these programs should include technology and the Internet in their teaching approaches to meet the drastic changes in the translation process, which seems to rely more on software and technologies to accomplish the translator’s tasks. Finally, translator training has borrowed many of its approaches from other disciplines, mainly language teaching. The teaching approaches in translator training have gone through some developments, from teacher-centered to student-centered and then toward the integration of technologies and the Internet. Both internal and external causes have played a crucial role in these developments. These borrowed approaches should be comprehensively evaluated in order to see if they achieve the goals of translator training. Such evaluation may lead us to come up with new teaching approaches developed specifically for translator training. While considering these methods and designing new approaches, we need to keep an eye on the future needs of the market.

Keywords: turning points, developments, translator training, market, The West

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Authors: Amos Sunday Onikanni, Bashir Lawal, Babatunji Emmanuel Oyinloye, Gomaa Mostafa-Hedeab, Mohammed Alorabi, Simona Cavalu, Augustine O. Olusola, Chih-Hao Wang, Gaber El-Saber Batiha

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The increasing global burden of diabetes mellitus has called for the search for a therapeutic alternative that offers better activities and safety than conventional chemotherapy. Herein, we evaluated the neuroprotective and antioxidant properties of different fractions (ethyl acetate, N-butanol and residual aqueous) of Clompanus pubescens leaves in streptozotocin (STZ)-induced diabetic rats. Our results revealed a significant elevation in the levels of blood glucose, pro-inflammatory cytokines, lipid peroxidation, neuronal activities of acetylcholinesterase, butyrylcholinesterase, nitric oxide, epinephrine, norepinephrine, and Na+/K+-ATPase in diabetic non treated rats. In addition, decreased levels of enzymatic and non-enzymatic antioxidants were observed. Treatment with different fractions of C. pubescens leaves resulted in a significant reversal of the biochemical alteration and improved the neurocognitive deficit in STZ-induced diabetic rats. However, the ethyl-acetate fraction demonstrated higher activities than the other fractions and was characterized for its phytoconstituents, revealing the presence of Gallic acid (713.00 ppm), catechin (0.91 ppm), ferulic acid (0.98 ppm), rutin (59.82 ppm), quercetin (3.22 ppm) and kaempferol (4.07 ppm). Our molecular docking analysis revealed that these compounds exhibited different binding affinities and potentials for targeting BChE/AChE/ IL-1 β/Na+-K+-ATPase. However, only Kampferol and ferulic exhibited good drug-like, ADMET, and permeability properties suitable for use as a neuronal drug target agent. Hence, the ethyl-acetate fraction of C. pubescent leaves could be considered a source of promising bioactive metabolite for the treatment and management of cognitive impairments related to type II diabetes mellitus.

Keywords: diabetes mellitus, neuroprotective, antioxidant, pro-inflammatory cytokines

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Authors: Rachel Goh, Alexander McNab, Brent Alsop, David O'Hare

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In a busy airport, the decision whether to take passengers aside and search their luggage for dangerous items can have important consequences. If an officer fails to search and stop a bag containing a dangerous object, a life-threatening incident might occur. But stopping a bag unnecessarily means that the officer might lose time searching the bag and face an angry passenger. Passengers’ bags, however, are often cluttered with personal belongings of varying shapes and sizes. It can be difficult to determine what is dangerous or not, especially if the decisions must be made quickly in cases of busy flight schedules. Additionally, the decision to search bags is often made with input from the surrounding officers on duty. This scenario raises several questions: 1) Past findings suggest that humans are more reliant on an automated aid when under time pressure in a visual search task, but does this translate to human-human reliance? 2) Are humans more likely to agree with another person if the person is assumed to be an expert or a novice in these ambiguous situations? In the present study, forty-one participants performed a simulated luggage-screening task. They were partnered with an advisor of two different statuses (expert vs. novice), but of equal accuracy (90% correct). Participants made two choices each trial: their first choice with no advisor input, and their second choice after advisor input. The second choice was made within either 2 seconds or 8 seconds; failure to do so resulted in a long time-out period. Under the 2-second time pressure, participants were more likely to disagree with their own first choice and agree with the expert advisor, regardless of whether the expert was right or wrong, but especially when the expert suggested that the bag was safe. The findings indicate a tendency for people to assume less responsibility for their decisions and defer to their partner, especially when a quick decision is required. This over-reliance on others’ opinions might have negative consequences in real life, particularly when relying on fallible human judgments. More awareness is needed regarding how a stressful environment may influence reliance on other’s opinions, and how better techniques are needed to make the best decisions under high stress and time pressure.

Keywords: advisors, decision-making, time pressure, trust

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Authors: R. M. Kilonzo, S. Bedingfield, K. Smith, K. Hudgins Smith, K. Couper, R. Ratley, Z. Taylor, A. Engelman, M. Renne

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Introduction: The mental health needs of university students continue to evolve, necessitating a strategic approach to service delivery. The East Tennessee State University (ETSU) Counseling Center developed its inaugural Strategic Plan (2024-2028) to enhance student mental health services. The plan focuses on improving access, quality of care, and service visibility, aligning with the university’s mission to support academic success and student well-being. Aim: This strategic plan aims to establish a comprehensive framework for delivering high-quality, evidence-based mental health services to ETSU students, addressing current challenges, and anticipating future needs. Methods: The development of the strategic plan was a collaborative effort involving the Counseling Center’s leadership, staff, with technical support from Doctor of Public Health-community and behavioral health intern. Multiple workshops, online/offline reviews, and stakeholder consultations were held to ensure a robust and inclusive process. A SWOT analysis and stakeholder mapping were conducted to identify strengths, weaknesses, opportunities, and challenges. Key performance indicators (KPIs) were set to measure service utilization, satisfaction, and outcomes. Results: The plan resulted in four strategic priorities: service application, visibility/accessibility, safety and satisfaction, and training programs. Key objectives include expanding counseling services, improving service access through outreach, reducing stigma, and increasing peer support programs. The plan also focuses on continuous quality improvement through data-driven assessments and research initiatives. Immediate outcomes include expanded group therapy, enhanced staff training, and increased mental health literacy across campus. Conclusion and Recommendation: The strategic plan provides a roadmap for addressing the mental health needs of ETSU students, with a clear focus on accessibility, inclusivity, and evidence-based practices. Implementing the plan will strengthen the Counseling Center’s capacity to meet the diverse needs of the student population. To ensure sustainability, it is recommended that the center continuously assess student needs, foster partnerships with university and external stakeholders, and advocate for increased funding to expand services and staff capacity.

Keywords: strategic plan, university counseling center, mental health, students

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