Search results for: public hospital unions

Authors: Renjith George, Preethy Mary Donald

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Use of internet sources to retrieve health care related information among health care professionals has increased tremendously as the accessibility to internet is made easier through smart phones and tablets. Though there are huge data available at a finger touch, it is doubtful whether all the sources providing health care information adhere to evidence based practice. The objective of this survey was to study the prevalence of use of internet sources to get health care information, to assess the mind-set towards the authenticity of health care information available via internet sources and to study the awareness about evidence based practice in health care among medical and dental students in Melaka-Manipal Medical College. The survey was proposed as there is limited number of studies reported in the literature and this is the first of its kind in Malaysia. A cross sectional survey was conducted among the medical and dental students of Melaka-Manipal Medical College. A total of 521 students including medical and dental students in their clinical years of undergraduate study participated in the survey. A questionnaire consisting of 14 questions were constructed based on data available from the published literature and focused group discussion and was pre-tested for validation. Data analysis was done using SPSS. The statistical analysis of the results of the survey proved that the use of internet resources for health care information are equally preferred over the conventional resources among health care students. Though majority of the participants verify the authenticity of information from internet sources, there was considerable percentage of candidates who feels that all the information from the internet can be utilised for clinical decision making or were not aware about the need of verification of authenticity of such information. 63.7 % of the participants rely on evidence based practice in health care for clinical decision making while 34.2 % were not aware about it. A minority of 2.1% did not agree with the concept of evidence based practice. The observations of the survey reveals the increasing use of internet resources for health care information among health care students. The results warrants the need to move towards evidence based practice in health care as all health care information available online may not be reliable. The health care person should be judicious while utilising the information from such resources for clinical decision making.

Keywords: authenticity, evidence based practice, health care information, internet

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Authors: Miftahuddin Khilji

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The concept of human right is not alien to Islam. The Shari‘ah requires all its followers the sense of responsibility to perform their duties first and then claim their rights. This eventually guarantees the protection of human rights and ensures a peaceful society. The ultimate goal of Shari‘ah is to preserve five basic necessities which are also known as Maqasid ul Shari‘ah or Objectives of Islamic Law. This goal ensures for the members of society their rights without harming public welfare. Despite of the fact that human rights have been fully guaranteed by Islam and their compliance is required by Allah Almighty; not by any legislative body or other sovereign such as kings etc. However, many western writers, organizations and so called liberal thinkers try to create concerns, doubts and misconceptions in minds of the society members. A number of issues are pointed out and people are misguided about the concept of human rights in Islam. This paper aims to discuss main the concept of human rights in the light of perfect and balanced system of laws and principles of Shari‘ah and address those misconceptions and doubts by analyzing them and answering to questions raised about the subject. It would be an effort to prove that human rights are much more significant to Shari‘ah more than any other national or international legislative body.

Keywords: human rights, Islamic law, law, Shariah

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Authors: Obidimma Ezezika

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In light of the increasing importance of trust in development programs, the purpose of this study, was to identify how trust functions as an essential key determinant in successful innovation and technology development programs. Using projects in the agricultural sector as case studies, we determined how the concept of trust is understood. Our data collection relied on semi-structured, face-to-face interviews conducted as part of a larger study investigating the role of trust in development programs. Interview transcripts were analyzed to create a narrative on how trust is understood by the study’s participants and how trust functions in fostering innovation. We identified six themes and showed how trust plays an important factor in innovation. These themes included the practice of integrity and honesty; delivery of results in an accountable manner; capability and competency; sharing of the same objectives and interests; transparency about actions and intentions through clear communication; and the targeting of services toward the interests of the public. The results of this study can provide guidance on how to enhance implementation mechanisms and provide impetus for organizations to implement trust building activities in fostering effective innovation.

Keywords: trust, research, innovation, technology

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Authors: Marina Arino Martin, John McEvoy, Eakalak Khan

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Endoxifen is an active metabolite responsible for the effectiveness of tamoxifen, a chemotherapeutic drug widely used for endocrine responsive breast cancer and chemo-preventive long-term treatment. Tamoxifen and endoxifen are not completely metabolized in human body and are actively excreted. As a result, they are released to the water environment via wastewater treatment plants (WWTPs). The presence of tamoxifen in the environment produces negative effects on aquatic lives due to its antiestrogenic activity. Because endoxifen is 30-100 times more potent than tamoxifen itself and also presents antiestrogenic activity, its presence in the water environment could result in even more toxic effects on aquatic lives compared to tamoxifen. Data on actual concentrations of endoxifen in the environment is limited due to recent discovery of endoxifen pharmaceutical activity. However, endoxifen has been detected in hospital and municipal wastewater effluents. The detection of endoxifen in wastewater effluents questions the treatment efficiency of WWTPs. Studies reporting information about endoxifen removal in WWTPs are also scarce. There was a study that used chlorination to eliminate endoxifen in wastewater. However, an inefficient degradation of endoxifen by chlorination and the production of hazardous disinfection by-products were observed. Therefore, there is a need to remove endoxifen from wastewater prior to chlorination in order to reduce the potential release of endoxifen into the environment and its possible effects. The aim of this research is to isolate and identify bacteria strain(s) capable of degrading endoxifen into less hazardous compound(s). For this purpose, bacteria strains from WWTPs were exposed to endoxifen as a sole carbon and nitrogen source for 40 days. Bacteria presenting positive growth were isolated and tested for endoxifen biodegradation. Endoxifen concentration and by-product formation were monitored. The Monod kinetic model was used to determine endoxifen biodegradation rate. Preliminary results of the study suggest that isolated bacteria from WWTPs are able to growth in presence of endoxifen as a sole carbon and nitrogen source. Ongoing work includes identification of these bacteria strains and by-product(s) of endoxifen biodegradation.

Keywords: biodegradation, bacterial degraders, endoxifen, wastewater

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Authors: Christopher Manyamba

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Women in Malawi produce perform between 50-70 percent of all agricultural tasks and yet the majority remain food insecure. The aim of his paper is to build on existing mixed evidence that indicates that empowering women in agriculture is conducive to improving food security. The WEAI is used to provide evidence on the relationship between women’s empowerment in agriculture and household food security. A multinomial logistic regression is applied to the Women Empowerment in Agriculture Index (WEAI) components and the Household Hunger Scale. The overall results show that the WEAI can be used to determine household food insecurity; however it has to be contextually adapted. Assets ownership, credit, group membership and leisure time are positively associated with food security. Contrary to other literature, empowerment in having control and decisions on income indicate negative association with household food security. These results could potentially better inform public, private and civil society stakeholders’ dialogues in creating the most effective and sustainable interventions to help women attain long-term food security.

Keywords: food security, gender, empowerment, agriculture index, framework for African food security, household hunger scale

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Authors: Bela Siska Afrida, Wisnu Barlianto, Desy Wulandari, Ery Olivianto

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Background: Allergic asthma, caused by IgE-mediated allergic reactions, remains a global health issue with high morbidity and mortality rates. Immunotherapy is the only etiology-based approach to treating asthma, but no standard biomarkers have been established to evaluate the therapy’s effectiveness. This study aims to determine the correlation between the ratios of serum levels of HDM-specific IgE/total IgE and Asthma Control Test (ACT) score as a biomarker of the response to immunotherapy in pediatric allergic asthma patients. Patient and Methods: This retrospective cohort study involved 26 pediatric allergic asthma patients who underwent HDM-specific subcutaneous immunotherapy for 14 weeks at the Pediatric Allergy Immunology Outpatient Clinic at Saiful Anwar General Hospital, Malang. Serum levels of HDM-Specific IgE and Total IgE were measured before and after immunotherapy using Chemiluminescence Immunoassay and Enzyme-linked Immunosorbent Assay (ELISA) method. Changes in asthma control were assessed using the ACT score. The Wilcoxon Signed Ranked Test and Spearman correlation test were used for data analysis. Results: There were 14 boys and 12 girls with a mean age of 6.48 ± 2.54 years. The study showed a significant decrease in serum HMD-specific levels before immunotherapy [9.88 ± 5.74 kuA/L] compared to those of 14 weeks after immunotherapy [4.51 ± 3.98 kuA/L], p = 0.000. Serum Total IgE levels significant decrease before immunotherapy [207.6 ± 120.8IU/ml] compared to those of 14 weeks after immunotherapy [109.83 ± 189.39 IU/mL], p = 0.000. The ratios of serum HDM-specific IgE/total IgE levels significant decrease before immunotherapy [0.063 ± 0.05] compared to those of 14 weeks after immunotherapy [0.041 ± 0.039], p = 0.012. There was also a significant increase in ACT scores before and after immunotherapy (each 15.5 ± 1.79 and 20.96 ± 2.049, p = 0.000). The correlation test showed a weak negative correlation between the ratios of HDM-specific IgE/total IgE levels and ACT score (p = 0.034 and r = -0.29). Conclusion: In conclusion, this study showed that a decrease in HDM-specific IgE levels, total IgE levels, and HDM-specific IgE/total IgE ratios, and an increase in ACT score, was observed after 14 weeks of HDM-specific subcutaneous immunotherapy. The weak negative correlation between the HDM-specific IgE/total IgE ratio and the ACT score suggests that this ratio can serve as a potential biomarker of the effectiveness of immunotherapy in treating pediatric allergic asthma patients.

Keywords: HDM-specific IgE/total IgE ratio, ACT score, immunotherapy, allergic asthma

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Authors: N. Haj Salem, M. Belhadj, S. Ben Jomâa, R. Dhouieb, S. Saadi, M. A. Mesrati, A. Chadly

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Introduction: The hyoid bone is considered as one of many bones used to identify a missed person. There is a specificity of each population group in human identifications. Objective: To analyze the relationship between age, sex and metric parameters of hyoid bone in Tunisian population sample, using CT-scan. Materials and Methods: A prospective study was conducted in the Department of Forensic Medicine of FattoumaBourguiba Hospital of Monastir-Tunisia during 4 years. A total of 240 samples of hyoid bone were studied. The age of cases ranged from 18 days to 81 years. The specimens were collected only from the deceased of known age. Once dried, each hyoid bone was scanned using CT scan. For each specimen, 10 measurements were taken using a computer program. The measurements consisted of 6 lengths and 4 widths. A regression analysis was used to estimate the relationship between age, sex, and different measurements. For age estimation, a multiple logistic regression was carried out for samples ≤ 35 years. For sex determination, ROC curve was performed. Discriminant value finally retained was based on the best specificity with the best sensitivity. Results: The correlation between real age and estimated age was good (r²=0.72) for samples aged 35 years or less. The unstandardised canonical function equation was estimated using three variables: maximum length of the right greater cornua, length from the middle of the left joint space to the middle of the right joint space and perpendicular length from the centre point of a line between the distal ends of the right and left greater cornua to the centre point of the anterior view of the body of the hyoid bone. For sex determination, the ROC curve analysis reveals that the area under curve was at 81.8%. Discriminant value was 0.451 with a specificity of 73% and sensibility of 79%. The equation function was estimated based on two variables: maximum length of the greater cornua and maximum length of the hyoid bone. Conclusion: The findings of the current study suggest that metric analysis of the hyoid bone may predict the age ≤ 35 years. Sex estimation seems to be more reliable. Further studies dealing with the fusion of the hyoid bone and the current study could help to achieve more accurate age estimation rates.

Keywords: anthropology, age estimation, CT scan, sex determination, Tunisia

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Authors: Ammal M. Metwally, Lobna A. ElEtreby, Rehan M. Saleh, Ghada Abdrabou, Somia I. Salama, Amira Orabi, Mohamed Abdelrahman

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Hepatitis C virus infection is a public health threat in Egypt. To control infection, efforts should be spent to encourage healthy behavior. This study aimed to assess the level of behavioral development in order to create a positive environment for the adoption of the recommended behaviors. The study was conducted over one year from Jan. 2011 till Jan. 2012. Knowledge, attitude and behavior of 540 HCV patients and 102 of their contacts were assessed and the level of behavioral development was determined. The study revealed that the majority of patients and contacts knew that HCV infection is dangerous with perceived concern for early diagnosis and treatment. More than 75% knew the correct modes of transmission. The assessment showed positive attitudes towards the recommended practices with the intention to adopt those practices. Strategies to create opportunities to continue the recommended behaviors should be adopted together with the reinforcement of social support.

Keywords: hepatitis C virus, level of behavioral development, recommended behaviors

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Authors: Vladimir Simovic, Matija Varga, Robert Svetlacic

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Scientific work analytically explores and demonstrates techniques that can animate objects and geometric characters using CSS3 language by applying proper formatting and positioning of elements. This paper presents examples of optimum application of the CSS3 descriptive language when generating general web animations (e.g., billiards and movement of geometric characters, etc.). The paper presents analytically, the optimal development and animation design with the frames within which the animated objects are. The originally developed content is based on the upgrading of existing CSS3 descriptive language animations with more complex syntax and project-oriented work. The purpose of the developed animations is to provide an overview of the interactive features of CSS3 descriptive language design for computer games and the animation of important analytical data based on the web view. It has been analytically demonstrated that CSS3 as a descriptive language allows inserting of various multimedia elements into websites for public and internal sites.

Keywords: web animation recording, KML GML HTML5 forms, Cascading Style Sheets 3, Google Earth Professional

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Authors: Zidane Abderrezzaq

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In contrast to recent successful developments in macro monetary policies, the modelling, measurement and management of systemic financial stability has remained problematical. Indeed, the focus of most effort has been on improving individual, rather than systemic, bank risk management; the Basel II objective has been to bring regulatory bank capital into line with the (sophisticated) banks’ assessment of their own economic capital. Even at the individual bank level there are concerns over appropriate diversification allowances, differing objectives of banks and regulators, the need for a buffer over regulatory minima, and the distinction between expected and unexpected losses (EL and UL). At the systemic level the quite complex and prescriptive content of Basel II raises dangers of ‘endogenous risk’ and procyclicality. Simulations suggest that this latter could be a serious problem. In an extension to the main analysis we study how liquidity effects interact with banking structure to produce a greater chance of systemic breakdown. We finally consider how the risk of contagion might depend on the degree of asymmetry (tiering) inherent in the structure of the banking system. A number of our results have important implications for public policy, which this paper also draws out.

Keywords: systemic stability, financial regulation, credit risk, systemic risk

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Authors: Peder O. Laugen Heggdal, Oyvind Nordvik, Jonas Brannstrom, Flemming Vassbotn, Anne Kari Aarstad, Hans Jorgen Aarstad

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Background: Hearing loss (HL) affect people of all ages and stages in life. To author's best knowledge, if patients with an HL have reduced Generic Quality of life (QoL), has yet not been answered. Aim: The aim of the present study was to investigate the relationship between HL and generic and disease-specific Health Related Quality of Life (HRQoL) in adult patients (aged 18–78 years) with an HL, seeking Hearing Aid (HA). Material and Methods: 158 adult (aged 18-78 years) patients with HL, referred for HA fitting at Haukeland University Hospital in western Norway, participated in the study. Both first-time users, as well as patients referred for HA renewals, were included. First-time users had been pre-examined by an Ear Nose and Throat specialist. The questionnaires were answered before the actual HA fitting procedure. The pure-tone average (PTA; frequencies 0.5, 1, 2 and 4 kHz) was determined for each ear. The generic European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire general part and a shortened version of the Abbreviated Profile of Hearing Aid Benefit (APHAB) were answered. In addition, EORTC HRQoL answers from a general population and patients with former head and neck cancer served as comparison. Results: In general, no lowered HRQoL scores were determined among HL patients compared to the general population. Patients with unilateral HL to some extent showed lower HRQoL than those with bilateral HL (social function and fatigue). The APHAB scores correlated significantly with the EORTC HRQoL scores. By stepwise linear regression analysis, the APHAB scores were scored secondary to PTA (best ear), cognitive and physical function. Conclusion: HRQoL scores in HL patients, in general, seems to be at the population level, but the unilateral HL patients scored to some extent lower than the bilateral HI patients. APHAB and generic QoL scores levels are associated. Both HRQoL and APHAB scores are generated more complexly than anticipated.

Keywords: quality of life, hearing loss, hearing impairment, distress, depression, anxiety, hearing aid

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Authors: Suzanne Overstreet-Juenke

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Disproportionate minority contact (DMC) is a salient issue that has been found at every stage of the decision-making process in the juvenile justice system. Existing research indicates that DMC influences adjudication for drug, property, and personal crimes. Because intimate partner violence (IPV) is a major public health problem and global concern, the current study examines DMC at adjudication among youth charged for crimes of interpersonal violence. This research uses administrative, Court Designated Worker (CDW) data collected from 2014 to 2016. The results are contextualized using Steffensmeier’s version of focal concerns theory of judicial decision-making. This study assesses race and two seriousness of offense measures to establish whether a link exists between race and adjudication. The results of the study is similar to prior research on the topic. These results are discussed in terms of policy implications, limitations, and future research.

Keywords: race, disproportionate minority contact, focal concerns theory, juvenile

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Authors: Sopit Tubtimhin, Chaliya Wamaloon, Anchalee Supattagorn

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Background and Significance: Breast cancer is the most frequently diagnosed and leading cause of cancer death among women. This study aims to determine factors potentially predicting recurrence and long-term survival after the first recurrence in surgically treated patients between postmenopausal and younger women. Methods and Analysis: A retrospective cohort study was performed on 498 Thai women with invasive breast cancer, who had undergone mastectomy and been followed-up at Ubon Ratchathani Cancer Hospital, Thailand. We collected based on a systematic chart audit from medical records and pathology reports between January 1, 2002, and December 31, 2011. The last follow-up time point for surviving patients was December 31, 2016. A Cox regression model was used to calculate hazard ratios of recurrence and death. Findings: The median age was 49 (SD ± 9.66) at the time of diagnosis, 47% was post-menopausal women ( ≥ 51years and not experienced any menstrual flow for a minimum of 12 months), and 53 % was younger women ( ˂ 51 years and have menstrual period). Median time from the diagnosis to the last follow-up or death was 10.81 [95% CI = 9.53-12.07] years in younger cases and 8.20 [95% CI = 6.57-9.82] years in postmenopausal cases. The recurrence-free survival (RFS) for younger estimates at 1, 5 and 10 years of 95.0 %, 64.0% and 58.93% respectively, appeared slightly better than the 92.7%, 58.1% and 53.1% for postmenopausal women [HRadj = 1.25, 95% CI = 0.95-1.64]. Regarding overall survival (OS) for younger at 1, 5 and 10 years were 97.7%, 72.7 % and 52.7% respectively, for postmenopausal patients, OS at 1, 5 and 10 years were 95.7%, 70.0% and 44.5 respectively, there were no significant differences in survival [HRadj = 1.23, 95% CI = 0.94 -1.64]. Multivariate analysis identified five risk factors for negatively impacting on survival were triple negative [HR= 2.76, 95% CI = 1.47-5.19], Her2-enriched [HR = 2.59, 95% CI = 1.37-4.91], luminal B [HR = 2.29, 95 % CI=1.35-3.89], not free margin [HR = 1.98, 95%CI=1.00-3.96] and patients who received only adjuvant chemotherapy [HR= 3.75, 95% CI = 2.00-7.04]. Statistically significant risks of overall cancer recurrence were Her2-enriched [HR = 5.20, 95% CI = 2.75-9.80], triple negative [HR = 3.87, 95% CI = 1.98-7.59], luminal B [HR= 2.59, 95% CI = 1.48-4.54,] and patients who received only adjuvant chemotherapy [HR= 2.59, 95% CI = 1.48-5.66]. Discussion and Implications: Outcomes from this studies have shown that postmenopausal women have been associated with increased risk of recurrence and mortality. As the results, it provides useful information for planning the screening and treatment of early-stage breast cancer in the future.

Keywords: breast cancer, menopause status, recurrence-free survival, overall survival

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Authors: F. A. Hassona, M. D. Hashem, R. I. Melek, B. M. Hakeem

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A differential settlement at the end of a bridge near the interface between the abutment and the embankment is a persistent problem for highway agencies. The differential settlement produces the common ‘bump at the end of the bridge’. Reduction in steering response, distraction to the driver, added risk and expense to maintenance operation, and reduction in a transportation agency’s public image are all undesirable effects of these uneven and irregular transitions. This paper attempts to simulate the bump at the end of the bridge using PLAXIS finite element 2D program. PLAXIS was used to simulate a laboratory model called Bridge to Embankment Simulator of Transition (B.E.S.T.) device which was built by others to investigate this problem. A total of six numerical simulations were conducted using hardening- soil model with rational assumptions of missing soil parameters to estimate the bump at the end of the bridge. The results show good agreements between the numerical and the laboratory models. Important factors influencing bumps at bridge ends were also addressed in light of the model results.

Keywords: bridge approach slabs, bridge bump, hardening-soil, PLAXIS 2D, settlement

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Authors: Maaza Saeed, Caina Li

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The current 2-wave longitudinal study attempts to illuminate the well-established association between parental warm support and academic achievement through the mediating role of self-control while taking into account the moderating role of teacher emotional support. The present research has assessed 2569 Chinese students (aged 10-18 years, M = 13.27, SD = 0.67). They were recruited from the three public middle schools in Xi’an, a middle-sized city in the central part of China. Meditation analysis revealed that self-control mediated the relationship between parental warm support and academic achievement. Additionally, it was found the direct effect of parental warm support was not significant after controlling for the age and gender. Furthermore, moderation analysis revealed high parental warm support and higher teacher emotional support was related to increased self-control compared to lower teacher emotion support. The findings highlighted the importance of parental warm support, teacher emotional support, and self-control on academic achievement.

Keywords: self control, academic achievement, teacher emotional support/conflict, adolescent

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Authors: Lorena Munoz

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Since the 1990s cities in the global south have implemented revanchist neoliberal urban regeneration policies that cater to urban elites based on “recovering” public space for capital accumulation purposes. These policies often work to reify street vending as survival strategies of ‘last resort’ for marginalized people and as an unorganized, unsystematic economic activities that needs to be disciplined, incorporated and institutionalized into the formal economy. This paper suggests, that by moving away from frameworks that reify formal/informal spheres of the economy, we are able to disrupt and rethink normative understandings of economic practices categorized as ‘informal’. Through queering economies, informal workers center their own understandings of self-value and legitimacy informing their economic lives and contributions to urban life. As such, queering the economy opens up possibilities of rethinking urban redevelopment policies that incorporate rather than remove street vendors, as their economic practices are incorporated into the everyday fabric and aesthetic of urban life.

Keywords: queering economies, street vendors, immigrant economies, race and nationality

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Authors: Made Rahayu Putri Saron, Mochamad Nizar Palefi Ma’ady

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Communication skills are important in everyday life, communication can be done verbally in the form of oral or written and nonverbal in the form of expressions or body movements. Good communication should be able to provide information clearly, and there is feedback from the speaker and listener. However, it is often found that the information conveyed is not clear, and there is no feedback from the listeners, so it cannot be ensured that the communication is effective and understandable. The speaker's understanding of the topic is one of the supporting factors for the listener to be able to accept the meaning of the conversation. However, based on the results of the literature review, it found that the influence factors of person speaking style are as follows: (i) environmental conditions; (ii) voice, articulation, and accent; (iii) gender; (iv) personality; (v) speech disorders (Dysarthria); when speaking also have an important influence on speaker’s speaking style. It can be concluded the factors that support understanding and comfort of the listener are dependent on the nature of the speaker (environmental conditions, voice, gender, personality) or also it the speaker have speech disorders.

Keywords: listener, public speaking, speaking style, understanding, and comfortable factor

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Authors: Katherine van Kampen, Reva Qiu, Patricia Farrugia

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Orthopedic surgery has fallen behind when it comes to gender diversity despite medical school classes reaching gender parity. Studies have shown that orthopedic surgery would require 117 years to reach gender parity with the trainee population, the longest time than any other specialty, including neurosurgery, urology, and otolaryngology. The barriers that face women in orthopedic surgery have been well researched, with contributing factors being on-going stereotypes of the field, lack of women mentors, and gender roles outside of the hospital. Furthermore, women in orthopedic surgery face barriers to achieve promotion, publications, and leadership roles leading to a “leaky pipeline,” resulting in less and less women in key academic roles in the field. It is a complex topic with barriers and challenges faced in medical school, residency, and throughout employment. Our scoping review seeks to understand these challenges across a temporal timeline and to further characterize such barriers and the driving factors behind them. To this date, authors did not find a scoping review that seeks to look broadly at factors impacting the decreased amount of women entering orthopedics and the factors that cause women to hit a “glass ceiling”, the idea that women will not achieve the same success as men despite the same qualifications, upon entering the field. This scoping review is the first of its kind to attempt to summarize the large body of research focusing on women in orthopedic surgery from the preconceptions in medical school impacting their desire to pursue orthopedics all the way to employment, including challenges to academic success and financial success. Literature databases will be searched with the following key terms: women, gender inequity, workforce, orthopedics, and citations will be hand searched and collected. Articles included will discuss gender inequality within orthopedics with non-english, patient related articles excluded. Full-text review will seek to characterize the specific barriers faced by women across medical school, residency, and employment. Themes that are expected to be highlighted are workforce data, women in orthopedic leadership, medical student perspectives on the specialty, and gender bias and discrimination in the field.

Keywords: orthopedics, gender equity, workforce, women in surgery

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Authors: Seung Won Park

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Pornographic images are becoming increasingly normalized as innovations in media technology arise, the porn industry explosively grows, and transnational capitalism spreads due to government deregulation and privatization of media. As the media evolves, pornography has become more and more violent and non-consensual; this growth of ‘raunch culture’ reifies the traditional power balance between men and women in which men are dominant, and women are submissive. This male domination objectifies and commodifies women, reducing them to merely sexual objects for the gratification of men. Women are exposed to pornographic images at younger and younger ages, providing unhealthy sexual role models and teaching them lessons on sexual behavior before the onset of puberty. The increasingly sexualized depiction of women in particular positions them as appropriately desirable and available to men. As a result, women are not only viewed as sexual prey but also end up treating themselves primarily as sexual objects, basing their worth off of their sexuality alone. Although many scholars are aware of and have written on the great lack of agency exercised by women in these representations, the general public tends to view some of these women as being empowered, rather than exploited. Scholarly discourse is constrained by the popular misconception that the construction of women’s sexuality in the media is controlled by women themselves.

Keywords: construction of gender, hypersexualization, media, objectification

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Authors: Hela Ben Maallem

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Applications based on virtual reality offer many benefits to the heritage and tourism sector. Digital heritage mediation is a constantly emerging field that aims to reconstruct the history of heritage items and sites, while at the same time highlighting the identity of a community or region and encouraging public engagement. This research focuses on the analysis of a virtual reality application used in a heritage digital mediation project. The modality introduced is examined through a case study of Djerba View VR application. The aim of this study is to understand the nature and potential uses of this immersive technology and to focus on the study of the possibilities of this medium. The goal of this article is to analyze how 3D reconstruction and immersive storytelling can offer an immersive, interactive and engaging user experience, while meeting the expectations and needs of visitors in a context of technological transition and user-centred design.

Keywords: digital heritage mediation, technological transition, virtual reality, 3D reconstruction, immersive storytelling, user experience, user centered design, interactivity, immersion

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Authors: Gnanachandrasamy G., Zhou Y., Ramkumar T., Venkatramanan S., Wang S., Mo Liping, Jingru Zhang

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In order to assess the heavy metal contamination totally fourty five groundwater samples were collected from the coastal part of Cauvery deltaic region, South India, during monsoon season in the year of 2017. The study area lies between longitudes 79º15’ to 79º 50’ E and latitudes 10º10’ to 11º20’ N with total area of 2,569 km². The concentration of As, Ba, Cd, Cr, Co, Cu, Ni, Pb, Se, and Zn were analyzed by Inductively Coupled Plasma Mass Spectrometry (ICP-MS). The heavy metals ranged between 0.007-117.8 µg/l for As, 8.503-1281 µg/l for Ba, 0.006-0.12 µg/l for Cd, 0.23-5.572µg/l for Cr, 0.44-17.9 µg/l for Co, 0.633-11.56 µg/l for Cu, 0.467-29.34 µg/l for Ni, 0.008-5.756 µg/l for Pb, 0.979 to 45.49 µg/l for Se, and 2.712-10480 µg/l for Zn in the groundwaters. A comparison of heavy metal concentration with WHO and BIS drinking water standards shows that Ni, Zn, As, Se, and Ba level is higher than the drinking water standards in some of the groundwater samples, and the concentrations of all the other heavy metals were lower than the drinking water standards. The present levels of heavy metal concentration in the studied area groundwaters are moderate to severe to public health and environmental concerns and need attention.

Keywords: cauvery delta, drinking water, groundwater, heavy metals

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Authors: Jared Oluoch

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Connected vehicles are equipped with wireless sensors that aid in Vehicle to Vehicle (V2V) and Vehicle to Infrastructure (V2I) communication. These vehicles will in the near future provide road safety, improve transport efficiency, and reduce traffic congestion. One of the challenges for connected vehicles is how to ensure that information sent across the network is secure. If security of the network is not guaranteed, several attacks can occur, thereby compromising the robustness, reliability, and efficiency of the network. This paper discusses existing security mechanisms and unique properties of connected vehicles. The methodology employed in this work is exploratory. The paper reviews existing security solutions for connected vehicles. More concretely, it discusses various cryptographic mechanisms available, and suggests areas of improvement. The study proposes a combination of symmetric key encryption and public key cryptography to improve security. The study further proposes message aggregation as a technique to overcome message redundancy. This paper offers a comprehensive overview of connected vehicles technology, its applications, its security mechanisms, open challenges, and potential areas of future research.

Keywords: VANET, connected vehicles, 802.11p, WAVE, DSRC, trust, security, cryptography

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Authors: A. Aslihan Gokaltun, Martin L. Yarmush, Ayse Asatekin, O. Berk Usta

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Poly(dimethylsiloxane) (PDMS) is one of the most widely used materials in the fabrication of microfluidic devices. It is easily patterned and can replicate features down to nanometers. Its flexibility, gas permeability that allows oxygenation, and low cost also drive its wide adoption. However, a major drawback of PDMS is its hydrophobicity and fast hydrophobic recovery after surface hydrophilization. This results in significant non-specific adsorption of proteins as well as small hydrophobic molecules such as therapeutic drugs limiting the utility of PDMS in biomedical microfluidic circuitry. While silicon, glass, and thermoplastics have been used, they come with problems of their own such as rigidity, high cost, and special tooling needs, which limit their use to a smaller user base. Many strategies to alleviate these common problems with PDMS are lack of general practical applicability, or have limited shelf lives in terms of the modifications they achieve. This restricts large scale implementation and adoption by industrial and research communities. Accordingly, we aim to tailor biocompatible PDMS surfaces by developing a simple and one step bulk modification approach with novel smart materials to reduce non-specific molecular adsorption and to stabilize long-term cell analysis with PDMS substrates. Smart polymers that blended with PDMS during device manufacture, spontaneously segregate to surfaces when in contact with aqueous solutions and create a < 1 nm layer that reduces non-specific adsorption of organic and biomolecules. Our methods are fully compatible with existing PDMS device manufacture protocols without any additional processing steps. We have demonstrated that our modified PDMS microfluidic system is effective at blocking the adsorption of proteins while retaining the viability of primary rat hepatocytes and preserving the biocompatibility, oxygen permeability, and transparency of the material. We expect this work will enable the development of fouling-resistant biomedical materials from microfluidics to hospital surfaces and tubing.

Keywords: cell culture, microfluidics, non-specific protein adsorption, PDMS, smart polymers

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Authors: Fakieh Alrabai

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This paper presents an experimental study designed to explore some of the learner’s individual and interpersonal factors (e.g. persistence, interest, regulation, satisfaction, appreciation, etc.) that Saudi learners experience when learning English as a Foreign Language and how learners’ perceptions of these factors influence various aspects of their motivation to learn English language. As part of the study, a 27-item structured survey was administered to a randomly selected sample of 105 Saudi learners from public schools and universities. Data collected through the survey were subjected to some basic statistical analyses, such as "mean" and "standard deviation". Based on the results from the analysis, a number of generalizations and conclusions are made in relation to how these inherent factors affect Saudi learners’ motivation to learn English as a foreign language. In addition, some recommendations are offered to Saudi academics on how to effectively make use of such factors, which may enable Saudi teachers and learners of English as a foreign language to achieve better learning outcomes in an area widely associated by Saudis with lack of success.

Keywords: persistence, interest, appreciation, satisfaction, SL/FL motivation

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Authors: Liu Linxin

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As system complexity increases, log parsing and anomaly detection become more and more important in ensuring system stability. However, traditional methods often face the problems of insufficient adaptability and decreasing accuracy when dealing with rapidly changing log contents and unknown domains. To this end, this paper proposes an approach LogRAG, which combines RAG (Retrieval Augmented Generation) technology with Prompt Engineering for Large Language Models, applied to log analysis tasks to achieve dynamic parsing of logs and intelligent anomaly detection. By combining real-time information retrieval and prompt optimisation, this study significantly improves the adaptive capability of log analysis and the interpretability of results. Experimental results show that the method performs well on several public datasets, especially in the absence of training data, and significantly outperforms traditional methods. This paper provides a technical path for log parsing and anomaly detection, demonstrating significant theoretical value and application potential.

Keywords: log parsing, anomaly detection, retrieval-augmented generation, prompt engineering, LLMs

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Authors: Hossein Rassi, Marjan Moradi Fard, Masoud Houshmand

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Background: Cervical cancer is multistep disease that is thought to result from an interaction between genetic background and environmental factors. Human papillomavirus (HPV) infection is the leading risk factor for cervical intraepithelial neoplasia(CIN)and cervical cancer. In other hand, some of p53 and miRNA polymorphism may plays an important role in carcinogenesis. This study attempts to clarify the relation of p53 genotypes and miR-146a rs2910164 polymorphism in cervical lesions. Method: Forty two archival samples with cervical lesion retired from Khatam hospital and 40 sample from healthy persons used as control group. A simple and rapid method was used to detect the simultaneous amplification of the HPV consensus L1 region and HPV-16,-18, -11, -31, 33 and -35 along with the b-globin gene as an internal control. We use Multiplex PCR for detection of P53 and miR-146a rs2910164 genotypes in our lab. Finally, data analysis was performed using the 7 version of the Epi Info(TM) 2012 software and test chi-square(x2) for trend. Results: Cervix lesions were collected from 42 patients with Squamous metaplasia, cervical intraepithelial neoplasia, and cervical carcinoma. Successful DNA extraction was assessed by PCR amplification of b-actin gene (99bp). According to the results, p53 GG genotype and miR-146a rs2910164 CC genotype was significantly associated with increased risk of cervical lesions in the study population. In this study, we detected 13 HPV 18 from 42 cervical cancer. Conclusion: The connection between several SNP polymorphism and human virus papilloma in rare researches were seen. The reason of these differences in researches' findings can result in different kinds of races and geographic situations and also differences in life grooves in every region. The present study provided preliminary evidence that a p53 GG genotype and miR-146a rs2910164 CC genotype may effect cervical cancer risk in the study population, interacting synergistically with HPV 18 genotype. Our results demonstrate that the testing of p53 codon 72 polymorphism genotypes and miR-146a rs2910164 polymorphism genotypes in combination with HPV18 can serve as major risk factors in the early identification of cervical cancers. Furthermore, the results indicate the possibility of primary prevention of cervical cancer by vaccination against HPV18 in Iran.

Keywords: cervical cancer, p53, miR-146a, rs2910164, polymorphism

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Authors: Evangelia Gaitanidou, Evangelos Bekiaris

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Considering that resilience implies the ability of a system to adapt continuously in order to respond to its operational goals, a system is considered as more or less resilient depending on the level and time of recovering from disruptive events and/or shocks to its initial state. Regarding transport systems, enhancing resilience is considered imperative for two main reasons: Such systems provide critical support to every socio-economic activity, while being one of the most important economic sectors and, secondly, the paths that convey people, goods and information, are the same through which risks are propagated. RESOLUTE (RESilience management guidelines and Operationalization appLied to Urban Transport Environment) Horizon 2020 research project is answering those needs, by proposing and testing a set of guidelines for resilience management of the urban transport system. The methods and steps towards this goal, through a step-wise methodology, taking into account established models like FRAM (Functional Resonance Analysis Model), and upon gathering existing practices are described in this paper, together with an overview of the produced guidelines. The overall aim is to create a framework which public transport authorities could consult and apply, for rendering their infrastructure resilient against natural disaster and other threats.

Keywords: guidelines, infrastructure, resilience, transport

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Authors: Phill-Seung Jung, Dae-Yeon Kim

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Objectives: In young, especially nulliparous women, it is not easy to decide on excisional therapy for cervical intraepithelial neoplasia (CIN). We aimed to evaluate how effective topical imiquimod is in the treatment of high-grade CIN so that excisional therapy can be avoided in young women. Methods: Patients with CIN were allocated to this pilot study. They did not want excisional therapy and agreed with topical imiquimod therapy, which required once-a-week hospital visit for 8 weeks for the application of imiquimod to the cervix by a gynecologic oncologist. If the lesion got worse during treatment, it was decided to convert imiquimod therapy to excisional therapy. Results: A total of 36 patients with a median age of 29 years (range, 22–41 years) agreed to receive topical imiquimod therapy. Of these, 32 patients (88.9%) were positive for high-risk human papillomavirus (HR HPV). Twenty-five patients (69.4%) had low-grade squamous intraepithelial lesion (LSIL), and 11 (30.6%) had high-grade squamous intraepithelial lesion (HSIL) on their initial LBC. Twenty-eight patients underwent punch biopsy, which showed CIN 1 in 7 (19.4%), CIN 2 in 11 (30.6%), and CIN 3 in 10 (27.8%) patients. Twenty patients finished the 8-week imiquimod therapy. Among them, 14 patients had CIN 2 or 3, and 6 patients had CIN 1. HR HPV was positive in 12 patients. On the last examination, 14 patients (70.0%) had negative intraepithelial lesions, 3 (15.0%) had atypical squamous cells of undetermined significance, and 1 (5.0%) had LSIL. Two patients had persistent HSIL: 1 patient underwent loop electrosurgical excision procedure, resulting in CIN 3 with positive resection margin, and the other patient underwent punch biopsy, resulting in intermediate cells and restarted imiquimod therapy. Only 7 patients were negative for HR HPV. Conclusions: This study showed that topical imiquimod therapy was effective for the treatment of high-grade CIN, with a histologic regression rate of 85.7% (14/20) and HPV eradication rate of 25.0% (8/32). Based on our findings, topical imiquimod therapy might have a successful therapeutic effect in young women with CIN 2-3 so that they can avoid excisional therapy. In addition, it could be a more reassuring treatment option for CIN 1 than just follow-up after few months. To confirm its efficacy, a phase II study with larger cohort would be needed.

Keywords: Imiquimod, Cervical Intraepthelial Neoplasia, Cervical Dysplasia, Human Papillomavirus

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Authors: Lazhar Belkhiri, Ammar Tiri, Lotfi Mouni

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Water resources present to the public order of the world a very important problem for the protection and management of water quality given the complexity of water quality data sets. In this study, the water quality index (WQI) and irrigation water quality index (IWQI) were calculated in order to evaluate the surface water quality for drinking and irrigation purposes based on nine hydrochemical parameters. In order to separate the variables that are the most responsible for the spatial differentiation, the discriminant analysis (DA) was applied. The results show that the surface water quality for drinking is poor quality and very poor quality based on WQI values, however, the values of IWQI reflect that this water is acceptable for irrigation with a restriction for sensitive plants. Consequently, the discriminant analysis DA method has shown that the following parameters pH, potassium, chloride, sulfate, and bicarbonate are significant discrimination between the different stations with the spatial variation of the surface water quality, therefore, the results obtained in this study provide very useful information to decision-makers

Keywords: surface water quality, drinking and irrigation purposes, water quality index, discriminant analysis

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Authors: Sahar Yousef, Chantelle Niblock, Gul Kacmaz

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Salt City, in the context of Jordan’s heritage landscape, is a significant case to explore when it comes to the interaction between tangible and intangible qualities of liveable cities. Most city centers, including Jerash, Salt, Irbid, and Amman, are historical locations. Six of these extraordinary sites were designated UNESCO World Heritage Sites. Jordan is widely acknowledged as a developing country characterized by swift urbanization and unrestrained expansion that exacerbate the challenges associated with the preservation of historic urban areas. The aim of this study is to conduct an examination and analysis of the existing condition of heritage connectivity within heritage city centers. This includes outdoor staircases, pedestrian pathways, footpaths, and other public spaces. Case study-style analysis of the urban core of As-Salt is the focus of this investigation. Salt City is widely acknowledged for its substantial tangible and intangible cultural heritage and has been designated as ‘The Place of Tolerance and Urban Hospitality’ by UNESCO since 2021. Liveability in urban heritage, particularly in historic city centers, incorporates several factors that affect our well-being; its enhancement is a critical issue in contemporary society. The dynamic interaction between humans and historical materials, which serves as a vehicle for the expression of their identity and historical narrative, constitutes preservation that transcends simple conservation. This form of engagement enables people to appreciate the diversity of their heritage recognising their previous and planned futures. Heritage preservation is inextricably linked to a larger physical and emotional context; therefore, it is difficult to examine it in isolation. Urban environments, including roads, structures, and other infrastructure, are undergoing unprecedented physical design and construction requirements. Concurrently, heritage reinforces a sense of affiliation with a particular location or space and unifies individuals with their ancestry, thereby defining their identity. However, a considerable body of research has focused on the conservation of heritage buildings in a fragmented manner without considering their integration within a holistic urban context. Insufficient attention is given to the significance of the physical and social roles played by the heritage staircases and baths that serve as connectors between these valued historical buildings. In doing so, the research uses a methodology that is based on consensus. Given that liveability is considered a complex matter with several dimensions. The discussion starts by making initial observations on the physical context and societal norms inside the urban center while simultaneously establishing the definitions of liveability and connectivity and examining the key criteria associated with these concepts. Then, identify the key elements that contribute to liveable connectivity within the framework of urban heritage in Jordanian city centers. Some of the outcomes that will be discussed in the presentation are: (1) There is not enough connectivity between heritage buildings as can be seen, for example, between buildings in Jada and Qala'. (2) Most of the outdoor spaces suffer from physical issues that hinder their use by the public, like in Salalem. (3) Existing activities in the city center are not well attended because of lack of communication between the organisers and the citizens.

Keywords: connectivity, Jordan, liveability, salt city, tangible and intangible heritage, urban heritage

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