Search results for: the relationship among art

Authors: Yun-Tsuen Chen, Shih-Ting Huang, Pi-Fen Cheng, Heng-Hua Wang, Hui-Zhu Chen

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This paper discusses the experience of caring for a patient diagnosed with breast cancer and later received total mastectomy during a 2nd trimester pregnancy. She was hospitalized from January 31 to February 4, 2018. Using 'Gordon’s 11 Functional Health Patterns' through physical exams and interviews, the researcher assessed the patient’s physical and mental health and determined the patient to have anxiety, acute pain, and body image disturbance. After establishing a strong relationship with the patient, the researcher helped the patient express her anxiety and personal feelings. A multi-specialist team was formed to evaluate both the patient and her unborn child, before, during, and after surgery. This individualized care allowed the patient and her child to optimize the post-operative results. Aside from medication, the patient also received non-medicinal treatment, including improvement of sleep quality with body positioning, diaphragmatic breathing exercises for pain and stress relief after surgery. Throughout hospitalization, the patient’s physical and emotional needs were addressed daily with listening sessions and empathy. The patient’s husband was also incorporated in the patient’s recovery by teaching both he and the patient how to change the sterile wound dressing, which may have the added benefit of improving marital relationships through shared activities of nurturing. The patient was also given advice about how to improve self-confidence through clothing. Lastly, the patient was encouraged to join a support group for breast cancer patients. Through the sharing of experience in groups and within the family, the patient was helped to adapt to the change of her appearance and re-establish her self-confidence. This level of care expedited the patient’s return to her family life and role of being a mother.

Keywords: anxiety, body image disturbance, breast cancer during pregnancy, multi-specialist team

Procedia PDF Downloads 98

Authors: Nicolas Bigot, M'hamed Boutaous, Nahiene Hamila, Shihe Xin

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Composite materials with polymer matrices are widely used in most industrial areas, particularly in aeronautical and automotive ones. Thanks to the development of a high-performance thermoplastic semicrystalline polymer matrix, those materials exhibit more and more efficient properties. The polymer matrix in composite materials can manifest a specific crystalline structure characteristic of crystallization in a fibrous medium. In order to guarantee a good mechanical behavior of structures and to optimize their performances, it is necessary to define realistic mechanical constitutive laws of such materials considering their physical structure. The interaction between fibers and matrix is a key factor in the mechanical behavior of composite materials. Transcrystallization phenomena which develops in the matrix around the fibers constitute the interphase which greatly affects and governs the nature of the fiber-matrix interaction. Hence, it becomes fundamental to quantify its impact on the thermo-mechanical behavior of composites material in relationship with processing conditions. In this work, we propose a numerical model coupling the thermal and crystallization kinetics in long fiber-based composite materials, considering both the spherulitic and transcrystalline types of the induced structures. After validation of the model with comparison to results from the literature and noticing a good correlation, a parametric study has been led on the effects of the thermal kinetics, the fibers volume fractions, the deformation, and the pressure on the crystallization rate in the material, under processing conditions. The ratio of the transcrystallinity is highlighted and analyzed with regard to the thermal kinetics and gradients in the material. Experimental results on the process are foreseen and pave the way to establish a mechanical constitutive law describing, with the introduction of the role on the crystallization rates and types on the thermo-mechanical behavior of composites materials.

Keywords: composite materials, crystallization, heat transfer, modeling, transcrystallization

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Authors: Maria Jose Granero Paris, Ana Isabel Jimenez Zarco, Agustin Pablo Alvarez Herranz

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In the industrial sector the collaboration along the supply chain is key especially in order to develop product, production methods or process innovations. The access to resources and knowledge not being available inside the company, the achievement of cost competitive solutions, the reduction of the time required to innovate are some of the benefits linked with the collaboration with suppliers. The big industrial manufacturers have a long tradition to collaborate with their suppliers to develop new products in the developed countries. Since they have increased their global supply chains and global sourcing activities, the objective of the research is to analyse if the same best practices, way of working, experiences, information technology tools, governance methodologies are applied when collaborating with suppliers in the developed world or in developing countries. Most of the current research focuses to analyse the Supply Chain Collaboration in the developed countries and in recent years the number of publications related to the Supply Chain Collaboration in developing countries has increased, but there is still a lack of research comparing both and analysing the similarities, differences and key success factors among the Supply Chain Collaboration practices in developed and developing countries. With this gap in mind, the research under preparation will focus on the following goals: -Identify the most important elements required for a successful supply chain collaboration in the developed and developing countries. -Set up the optimal governance framework to manage the supply chain collaboration in the developed and developing countries. -Define some recommendations about required improvements in the current supply chain collaboration business relationship practices in place. Following the case methodology we will analyze the way manufacturers and suppliers collaborate in the development of new products, production methods or process innovations and in the set up of new global supply chains in two industries with different level of technology intensity and collaboration history being the automotive and aerospace industries.

Keywords: global supply chain networks, Supply Chain Collaboration, supply chain governance, supply chain performance

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Authors: Paramvir Singh

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The locomotion of aquatic organisms has long fascinated biologists and engineers alike, with fish fins serving as a prime example of nature's remarkable adaptations for efficient underwater propulsion. This paper presents a comprehensive study focused on the hydrodynamic analysis of fish fin kinematics, employing an innovative approach that combines machine learning and image processing techniques. Through high-speed videography and advanced computational tools, we gain insights into the complex and dynamic motion of the fins of a Tilapia (Oreochromis Niloticus) fish. This study was initially done by experimentally capturing videos of the various motions of a Tilapia in a custom-made setup. Using deep learning and image processing on the videos, the motion of the Caudal and Pectoral fin was extracted. This motion included the fin configuration (i.e., the angle of deviation from the mean position) with respect to time. Numerical investigations for the flapping fins are then performed using a Computational Fluid Dynamics (CFD) solver. 3D models of the fins were created, mimicking the real-life geometry of the fins. Thrust Characteristics of separate fins (i.e., Caudal and Pectoral separately) and when the fins are together were studied. The relationship and the phase between caudal and pectoral fin motion were also discussed. The key objectives include mathematical modeling of the motion of a flapping fin at different naturally occurring frequencies and amplitudes. The interactions between both fins (caudal and pectoral) were also an area of keen interest. This work aims to improve on research that has been done in the past on similar topics. Also, these results can help in the better and more efficient design of the propulsion systems for biomimetic underwater vehicles that are used to study aquatic ecosystems, explore uncharted or challenging underwater regions, do ocean bed modeling, etc.

Keywords: biomimetics, fish fin kinematics, image processing, fish tracking, underwater vehicles

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Authors: Aynura Valiyeva, Basil John Thomas

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Intra-firm communication is critical for building synergy amongst internal business units of a firm, where employees from various functional departments and ranks incorporate their decision-making, understanding of organizational objectives, as well as common norms and culture for better organizational effectiveness. This study builds on and assesses a framework of the causes and consequences of effective communication in business interactions between customer and supplier firms, and the path for efficient communication within a firm. The proposed study’s structural equation modeling (SEM) analysis based on 352 sample responses collected from firm representatives at different job positions ranging from marketing to logistics operations, reveals that, in the frame of reference of intra-organizational communication, organization characteristics and shared values, top management support and style of leadership, as well as information technology, are all significantly related to communication effectiveness. Furthermore, the frequency and variety of interactions enhance the outcome of communication, that improves a company’s performance. The results reveal that cultural factors are significantly related to communication effectiveness, as well as the shared beliefs and goals. In terms of organizational factors, leadership style, top management support and information technology are significant determinants of effective communication. Among the contextual factors, interaction frequency and diversity are found to be priority factors. This study also tests the relationship between supplier and supplier firm performance in the context of communication effectiveness, and finds that they are closely related, when trust and commitment is built between business partners. When firms do business in other multicultural contexts, language and shared values with destination country must be considered significant elements of communication process.

Keywords: business performance, intra-firm communication, inter-firm communication, structural equation modeling

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Authors: Aytakin Huseynli

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The paper reports findings of the study which examined under-five mortality rate among resource-rich countries. Typically when countries obtain wealth citizens gain increased wellbeing. Societies with new wealth create equal opportunities for everyone including vulnerable groups. But scholars claim that this is not the case for developing resource-rich countries and natural resources become the curse for them rather than the blessing. Spillovers from natural resource curse affect the social wellbeing of vulnerable people negatively. They get excluded from the mainstream society, and their situation becomes tangible. In order to test this hypothesis, the study compared under-5 mortality rate among resource-rich countries by using independent sample one-way ANOVA. The data on under-five mortality rate came from the World Bank. The natural resources for this study are oil, gas and minerals. The list of 67 resource-rich countries was taken from Natural Resource Governance Institute. The sample size was categorized and 4 groups were created such as low, low-middle, upper middle and high-income countries based on income classification of the World Bank. Results revealed that there was a significant difference in the scores for low, middle, upper-middle and high-income countries in under-five mortality rate (F(3(29.01)=33.70, p=.000). To find out the difference among income groups, the Games-Howell test was performed and it was found that infant mortality was an issue for low, middle and upper middle countries but not for high-income countries. Results of this study are in agreement with previous research on resource curse and negative effects of resource-based development. Policy implications of the study for social workers, policy makers, academicians and social development specialists are to raise and discuss issues of marginalization and exclusion of vulnerable groups in developing resource-rich countries and suggest interventions for avoiding them.

Keywords: children, natural resource, extractive industries, resource-based development, vulnerable groups

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Authors: David Whitehouse

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Some of the strengths of online teaching include flexibility, creativity, and comprehensiveness. A challenge can be motivation. How can an instructor repeating the same lessons over and over, day in and day out, year after year, maintain motivation? Enthusiasm? Does motivating the student and creating enthusiasm in class build the same things inside the instructor? The answers lie in the adoption of what I label EUQ—The Empathy and Understanding Quotient. In the online environment, students who are adults have many demands on their time: civilian careers, families (spouse, children, older parents), and sometimes even military service. Empathetic responses on the part of the instructor will lead to open and honest communication on the part of the student, which will lead to understanding on the part of the instructor and a rise in motivation in both parties. Understanding the demands can inform an instructor’s relationship with the student throughout the temporal parameters of classwork. In practicing EUQ, instructors can build motivation in their students and find internal motivation in an enhanced classroom dynamic. The presentation will look at what motivates a student to accomplish more than the minimum required and how that can lead to excellent results for an instructor’s own motivation. Through direct experience of having students give high marks on post-class surveys and via direct messaging, the presentation will focus on how applying EUQ in granting extra time, searching for intent while grading, communicating with students via Quick Notes, responses in Forums, comments in Assignments, and comments in grading areas - - - how applying these things infuses enthusiasm and energy in the instructor which drive creativity in teaching. Three primary ways of communicating with students will be given as examples. The positive response and negative response each for a Forum, an Assignment, and a Message will be explored. If there is time, participants will be invited to craft their own EUQ responses in a role playing exercise involving two common classroom scenarios—late work and plagiarism.

Keywords: education, instruction, motivation, online, teaching

Procedia PDF Downloads 171

Authors: Nida Iftikhar, Jamaluddin Thaheem, Bilal Iftikhar

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In the construction industry, adequate and effective decision-making can mean the difference between success and failure. Bidding is the most important element of the construction business since it is a mean by which contractors obtain work. This is probably the only option for any contractor firm to sustain in the market and achieve its objective of earning the profits by winning tenders. The capability to select most appropriate ventures not only defines the success and wellbeing of contractor firms but also their survival and sustainability in the industry. The construction practitioners are usually on their own when it comes to deciding on bidding for a project or not. Usually, experience-based solutions are offered where a lot of subjectivity is involved. This research has been opted considering the local construction industry of Pakistan in order to examine the critical success factors from contractors’ perspective while making bidding decisions, listing and evaluating critical factors in order of their importance, categorization of these factors into decision support & decision oppose groups and to develop a framework to help contractors in the decision-making process. Literature review, questionnaires, and structured interviews are used for identification and quantification of factors affecting bid/no bid decision-making. Statistical methods of ranking analysis and analytical hierarchy process of multi-criteria decision-making method are used for analysis. It is found that profitability, need for work and financial health of client are the most decisive factors in bid/no bid decision-making while project size, project type, fulfilling the tender conditions imposed by the client and relationship, identity & reputation of the client are least impact factors in bid/no bid decision-making. Further, to verify the developed framework, case studies have been conducted to evaluate the bid/no bid decision-making in building procurement. This is the first of its nature study in the context of the local construction industry and recommends using a holistic decision-making framework for such business-critical deliberations.

Keywords: bidding, bid decision-making, construction procurement, contractor

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Authors: Salma I. Dwidar, Amal A. Abdelsattar

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Alexandria city is one of the greatest cities in the world. It confronted different civilizations throughout the ages due to its special geographical location and climate which left many archaeological areas of great heritage (Ptolemaic, Greek, Romanian, especially sunken monuments, Coptic, Islamic, and finally, the Modern). Also, Alexandria city contains areas with different patterns of urban planning, both Hellenistic and compacted planning which merited the diversity in planning. Despite the magnitude of this city, which contains all the elements of tourism, the city was not included in the tourism map of Egypt properly comparing with similar cities in Egypt. This paper discusses the importance of heritage areas in Alexandria and the relationship between heritage areas and modern buildings. It highlights the absence of a methodology to deal with heritage areas as touristic areas. Also, the paper aims to develop multiple touristic routes to visit archaeological areas and other sights of significance in Alexandria. The research methodology is divided into two main frameworks. The first framework is a historical study of the urban development of Alexandria and the most important remaining monuments throughout the ages, as well as an analytical study of sunken monuments and their importance in increasing the rate of tourism. Moreover, it covers a study of the importance of the Library of Alexandria and its effect on the international focus of the city. The second framework focuses on the proposal of some tourism routes to visit the heritage areas, archaeological monuments, sunken monuments and the sights of Alexandria. The study concludes with the proposal of three tourism routes. The first route, which is the longest one, passes by all the famous monuments of the city as well as its modern sights. The second route passes through the heritage areas, sunken monuments, and Library of Alexandria. The third route includes the sunken monuments and Library of Alexandria. These three tourism routes will ensures the touristic development of the city which leads to the economic growth of the city and the country.

Keywords: archeological buildings, heritage buildings, heritage tourism, planning of Islamic cities

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Authors: Claudia Koby, Merav Boaz, Meirav Zaiger Kober

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Krembo Wings is an all-inclusive youth movement which brings children and youth with any disability together with their able-bodied peers (counselors) for weekly fun and educational social activities. Krembo Wings utilizes a socio-educational framework to create and lead social change through members with and without disabilities. All the work that Krembo Wings engages in stems from its central goal of promoting inclusion and integration using social and psychological theories to develop its unique model and approach. The key to Krembo Wings' approach in promoting inclusion is active participation – each member, with and without disabilities, is enabled to participate to their fullest capacity in the youth movement and its activities. In order for this to be achieved, all activities are adjustable and are modified to fit the abilities of each member. Additionally, youth counselors – most of whom are members without disabilities – go through extensive training in order to act as 'intermediaries' for their partner with disabilities, enabling and facilitating their partner's participation in a way that allows them to be as independent and active as possible. The relationship is one of friendship and not of caretaking. There is always a nurse on-hand to tend to any caretaking needs. Two essential elements of Krembo Wings' model is the broadening of concepts – shifting and changing the understanding of certain concepts such as what it means to be 'independent' or 'able' – and the development of a unique language – creating a language which both reflects and shapes reality. These elements of Krembo Wings' model foster the development of the values of acceptance and appreciation of those who are 'different'. It instills in members and counselors a new way of perceiving the world, one in which inclusion and integration are achievable and natural. Krembo Wings is certain that implementation of this model will promote the participation and inclusion of individuals with disabilities in society while promoting diversity. This model can serve as a platform which can be replicated and adjusted to suit any environment.

Keywords: innovative model for inclusion, socio-educational movement, youth leadership, youth with and without disabilities

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Authors: Diego Alejandro Espíndola-Fernández, Ana María Posada-Cano, Dagnóvar Aristizábal-Ocampo, Jaime Alberto Gallo-Villegas

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Background: With the increase in life expectancy, aging has been subject of frequent research, and therefore multiple strategies have been proposed to quantify the advance of the years based on the known physiology of human senescence. For several decades, attempts have been made to characterize these changes through the concept of biological age, which aims to integrate, in a measure of time, structural or functional variation through biomarkers in comparison with simple chronological age. The objective of this scoping review is to deepen the updated concept of measuring biological age composed of biomarkers in the general population and to summarize recent evidence to identify gaps and priorities for future research. Methods: A scoping review was conducted according to the five-phase methodology developed by Arksey and O'Malley through a search of five bibliographic databases to February 2021. Original articles were included with no time or language limit that described the biological age composed of at least two biomarkers in those over 18 years of age. Results: 674 articles were identified, of which 105 were evaluated for eligibility and 65 were included with information on the measurement of biological age composed of biomarkers. Articles from 1974 of 15 nationalities were found, most observational studies, in which clinical or paraclinical biomarkers were used, and 11 different methods described for the calculation of the composite biological age were informed. The outcomes reported were the relationship with the same measured biomarkers, specified risk factors, comorbidities, physical or cognitive functionality, and mortality. Conclusions: The concept of biological age composed of biomarkers has evolved since the 1970s and multiple methods of its quantification have been described through the combination of different clinical and paraclinical variables from observational studies. Future research should consider the population characteristics, and the choice of biomarkers against the proposed outcomes to improve the understanding of aging variables to direct effective strategies for a proper approach.

Keywords: biological age, biological aging, aging, senescence, biomarker

Procedia PDF Downloads 186

Authors: S. M. Rashed Ul Islam, Shahina Tabassum, Afsana Anwar Miti

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Objective: HIV testing and counseling center (HTC) is an important component of the HIV/AIDS detection, prevention and control interventions. The service was first initiated at the Department of Virology, Bangabandhu Sheikh Mujib Medical University (BSMMU) since the first case detection in 1989. The present study aimed to describe the demographic profile among the attendees tested HIV positive. Methods: The present study was carried out among 219 HIV positive cases detected through screening at the Department of Virology of BSMMU during the year of 2012-2016. Data were collected through pre-structured written questionnaire during the counseling session. Data were expressed as frequency and percentages and analyzed using SPSS v20.0 program. Results: Out of 219 HIV cases detected, 77.6% were males, and 22.4% were females with a mean age (mean±SD) of 35.46±9.46 years. Among them, 70.7% belonged to the 26-45 age groups representing the sexually active age. The majority of the cases were married (86.3%) and 49.8% had primary level of education whereas, 8.7% were illiterate. Nearly 42% of cases were referred from Chittagong division (south-east part of the country) followed by Dhaka division (35.6%). The bulk of study population admitted to involvement in high-risk behaviour (90%) in the past and 42% of them had worked overseas. The Pearson Chi-square (χ2) analysis revealed significant relationship of gender with marital (χ2=7.88 at 2% level) and occupation status (χ2=120.48 at 6% level); however, no association was observed with risk behaviour and educational status. Recommendations: HIV risk behavior was found to be a prime source for HIV infection among the study population. So, there is need for health education and awareness program to bring about behavioral changes to halt the yearly increase of new cases in the country with special attention to our overseas workers on HIV/AIDS risk and safety.

Keywords: Bangladesh, health education, HIV testing and counseling (HTC), HIV/AIDS, risk behavior

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Authors: Tahar Tayachi, Ahlam Alrehaili

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Purpose: The purpose of this paper is to investigate the relationship between the corporate board characteristics and the dividend policy among firms on the Saudi Stock Exchange. Design/Methodology/Approach: This paper uses a sample of 103 nonfinancial firms over a time period of 4 years from 2015 to 2018. To investigate how corporate governance mechanisms such as board independence, the board size, frequency of meetings, and free cash flow impact dividends, the study uses Logit and Tobit models. Findings: This paper finds that board size, board independence, and frequency of board meetings have no influence on a firm’s decision to pay dividends, while board size has a significantly positive impact on the levels of cash dividends paid to investors. This study also finds that the level of free cash flows has a positively significant influence on both the decision to pay dividends and the magnitude of dividend payouts. Research Limitations/Implications: This paper attempts to study the effectiveness of dividend policy among some firms on the Saudi Stock Exchange. Practical Implications: The findings reveal that board characteristics, which represent one of the crucial mechanisms of corporate governance, were found to be complementary to corporate laws and regulations imposed on the Saudi market in 2015. The findings also imply that capital market authorities should revise their corporate regulations and ensure that protection laws are adequate and strong enough to protect the interests of all shareholders. Originality/Value: This paper is among the few studies focusing on dividend policy in Saudi Arabia. Finally, these findings suggest that the improvements in corporate laws in Saudi Arabia led to such an outcome, and it has become prevalent in dividend policy decisions and behaviors of Saudi firms.

Keywords: agency theory, Tobit, corporate governance, dividend payout, Logit

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Authors: Rafiu Babatunde Ibrahim, Richard Oluseyi Taiwo, Abiodun Toheeb Akintunde

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The relationship between road transport infrastructure and commercial activities in Nigeria has been a topical issue and identified as one of the crucial components for economic development in the country. This study examines road transport infrastructure and commercial activities along selected roads in Ede, Nigeria. The study assesses the characteristics of the selected roads, the condition of road infrastructure, the degree of road network connectivity, maintenance culture for the road infrastructure as well as commercial activities along identified roads in the study area. Stratified Sampling Techniques were used to partition the study area into core, Intermediate and Suburb Township zones. Roads were also classified into Major, Distributor and Access Roads. Field observation and measurement, as well as a questionnaire, were used to obtain primary data from 246 systematically sampled respondents along the roads selected, and they were analyzed using descriptive and inferential statistics. The study revealed that most of the roads were characterized by an incidence of potholes. A total of 448 potholes were observed, where Olowoibida Road accounted for (19.0%), Federal Polytechnic Road (17.4%), and Back to Land Road (16.3%). The majority of the selected roads have no street lights and are of open drainage systems. Also, the condition of road surfaces was observed to be deteriorating. Road network connectivity of the study area was found to be poorly connected with 11% using the alpha index and 40% of Gamma index. It was found that the tailoring business (39) is predominant on major roads and Distributor Roads, while petty trading (35) is dominant on the access road. Results of correlation analysis (r = 0.242) show that there is a low positive correlation between road infrastructure and commercial activities; the significant relationships have indeed explained how important it is in influencing commercial activities across the study area. The study concluded by emphasizing the need for the provision of more roads and proper maintenance of the existing ones. This will no doubt improve the commercial activities along the roads in the study area.

Keywords: road transport, infrastructure, commercial activities, maintenance culture

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Authors: Taimaz Larimian, Negin Sadeghi

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Very little is known about the impacts of urban security on the level of social sustainability within the cities of developing countries. Urban security is still struggling to find its position in the social sustainability agenda, despite the significant role of safety and security on different aspects of peoples’ lives. This paper argues that urban safety and security should be better integrated within the social sustainability framework. With this aim, this study investigates the hypothesized relationship between social sustainability and Crime Prevention through Environmental Design (CPTED) approach at the neighborhood scale. This study proposes a model of key influential dimensions of CPTED analyzed into localized factors and sub-factors. These factors are then prioritized using pairwise comparison logic and fuzzy group Analytic Hierarchy Process (AHP) method in order to determine the relative importance of each factor on achieving social sustainability. The proposed model then investigates social sustainability in six case study neighborhoods of Isfahan city based on residents’ perceptions of safety within their neighborhood. Mixed method of data collection is used by using a self-administered questionnaire to explore the residents’ perceptions of social sustainability in their area of residency followed by an on-site observation to measure the CPTED construct. In all, 150 respondents from selected neighborhoods were involved in this research. The model indicates that CPTED approach has a significant direct influence on increasing social sustainability in neighborhood scale. According to the findings, among different dimensions of CPTED, ‘activity support’ and ‘image/ management’ have the most influence on people’s feeling of safety within studied areas. This model represents a useful designing tool in achieving urban safety and security during the development of more socially sustainable and user-friendly urban areas.

Keywords: crime prevention through environmental design (CPTED), developing countries, fuzzy analytic hierarchy process (FAHP), social sustainability

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Authors: Roya Pournaghi

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Measuring the extent of daily use of the libraries study space is of utmost significance in order to develop, re-organize and maintain the efficiency of the study space. The current study aimed to employ GIS in analyzing the study halls space of the document center and central library of Tehran University and determine the extent of use of the study chairs and desks by the students-intended users. This combination of survey methods - descriptive design system. In order to collect the required data and a description of the method, To implement and entering data into ArcGIS software. It also analyzes the data and displays the results on the library floor map design method were used. And spatial database design and plan has been done at the Central Library of Tehran University through the amount of space used by members of the Library and Information halls plans. Results showed that Biruni's hall is allocated the highest occupancy rate to tables and chairs compared to other halls. In the Hall of Science and Technology, with an average occupancy rate of 0.39 in the tables represents the lowest users and Rashid al-Dins hall, and Science and Technology’s hall with an average occupancy rate (0.40) represents the lowest users of seats. In this study, the comparison of the space is occupied at different period as a study’s hall in the morning, evenings, afternoons, and several months was performed through GIS. This system analyzed the space relationship effectively and efficiently. The output of this study can be used by administrators and librarians to determine the exact amount of using the Equipment of study halls and librarians can use the output map to design more efficient space at the library.

Keywords: geospatial information system, spatial analysis, reading room, academic libraries, library’s user, central library of Tehran university

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Authors: Pawan Kumar Gupta, Sumana Ghosh

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Parkinson's Disease (PD) is a long-term neurodegenerative movement disorder of the central nervous system with vast symptoms related to the motor system. The common symptoms of PD are tremor, rigidity, bradykinesia/akinesia, and postural instability, but the clinical symptom includes other motor and non‐motor issues. The motor symptoms of the disease are consequence of death of the neurons in a region of the midbrain known as substantia nigra pars compacta, leading to decreased level of a neurotransmitter known as dopamine. The cause of this neuron death is not clearly known but involves formation of Lewy bodies, an abnormal aggregation or clumping of the protein alpha-synuclein in the neurons. Unfortunately, there is no cure for PD, and the management of this disease is challenging. Therefore, it is critical for a patient to be diagnosed at early stages. A limited choice of drugs is available to improve the symptoms, but those become less and less effective over time. Apart from that, with rapid growth in the field of science and technology, other methods such as multi-area brain stimulation are used to treat patients. In order to develop advanced techniques and to support drug development for treating PD patients, an accurate mathematical model is needed to explain the underlying relationship of dopamine secretion in the brain with the hand tremors. There has been a lot of effort in the past few decades on modeling PD tremors and treatment effects from a computational point of view. These models can effectively save time as well as the cost of drug development for the pharmaceutical industry and be helpful for selecting appropriate treatment mechanisms among all possible options. In this review paper, an effort is made to investigate studies on PD modeling and analysis and to highlight some of the key advances in the field over the past centuries with discussion on the current challenges.

Keywords: Parkinson's disease, deep brain stimulation, tremor, modeling

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Authors: Syahrul Bariah Abdul Hamid, Colin W. Binns, Jun Hui Chih

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The total of obese mothers is growing throughout Asia. Breastfeeding provides the perfect nutrition for infants, by promoting a higher IQ and protecting against childhood and adult diseases. A prospective cohort study was carried out of mothers attending eight antenatal clinics run by the Ministry of Health in Selangor, Malaysia to document the prevalence of obesity and its relationship with breastfeeding outcomes. Mothers were enrolled during the antenatal period and followed up until 6 months postpartum to document breastfeeding outcomes. A total of 652 Malay mothers were recruited for the study a response rate of 93.1 %. The pre-pregnancy body mass index (BMI) of the mothers showed that 36.5% of the mothers were overweight or obese. There were a total of 78 obese mothers in the sample and 41 (52.6%) of these mothers were able to initiate breastfeeding within one hour of birth compared to 238/337 (70.6 %, χ² 9.35, p<0.001) of those with a normal BMI. At 6 months, 23.1 % of obese mothers were exclusively breastfeeding their infants, compared to 56.0 % of the normal BMI mothers. On the other hand, the rate of infant formula feeding was higher in the obese mothers by 53.8 % compared to 19.0 % among normal weight mothers, χ² 37.6, p<0.001). Further analysis suggested these factors were found to be positively associated with discontinued exclusive breastfeeding at 6 months among obese mothers; mothers whom delayed breastfeeding initiation, had health problems during pregnancy, caesarean delivery, reported had insufficient colostrum/milk and babies had sucking problems at or before 4 weeks. Besides that, mothers who perceived their biological mothers had preference towards formula feeding or were ambivalent about the feeding method and had biological mothers without experience in breastfeeding for more than 1 month also were more likely to discontinue exclusive breastfeeding at 6 months. These findings suggested that the greater the pre-pregnant BMI, the earlier the cessation of exclusive breastfeeding and they were also less likely to initiate breastfeeding and have less adequate milk supply. Future investigations of the effects of maternal obesity on breastfeeding outcomes should be conducted along with effective interventions to advance the care of obese women at reproductive age and their children.

Keywords: exclusive breastfeeding, body mass index (BMI), breastfeeding discontinuation, maternal obesity

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Authors: Muhammad Sheeraz, Mehwish Ejaz

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This study endeavors to enhance the understanding of the determinants of oppositional brand loyalty, particularly within the context of fans of a sports brand. The primary focus is on investigating how oppositional brand loyalty fosters rivalry among the fans and exploring the interplay between various variables, namely self-congruence, consumer brand identification, consumer brand engagement, and narcissism, in influencing the likelihood of endorsing a rival team. The research adopts a cross-sectional survey methodology, employing a structured questionnaire distributed both online and onsite to gather responses from a representative sample of 460 PSL fans in Pakistan. The data collection process involved obtaining responses from diverse settings, including universities, shopping malls, and other public spaces frequented by PSL enthusiasts. Participants were prompted to indicate their allegiance to a specific PSL team and subsequently respond to the questionnaire based on their preferences. The findings of the study reveal that narcissism, as a moderating factor, exhibits no significant influence on consumer brand identification, consumer brand engagement, and oppositional brand loyalty. However, it does emerge as a significant moderator in the relationship between self-congruence and consumer brand identification. Particularly, consumers express brand identification through self-congruence, elucidating the existence of oppositional sentiments among PSL fans and their counterparts supporting rival teams. The implications of these results underscore the importance for marketers to establish a brand identity that resonates with consumers on a personal level. Such an approach fosters a strong sense of identification with the brand, prompting consumers to vigorously defend and support their favored brands, even in the face of opposition from rival teams. Marketers are encouraged to focus on cultivating long-term consumer loyalty, as it proves pivotal in maintaining a competitive advantage over industry counterparts.

Keywords: oppositional brand loyalty, consumer brand identification, consumer brand engagement, narcissism, self-congruence

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Authors: Moustafa Elwan, Sohier Shehata, Fatma Sedek, Manar Hussine

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One of the most risky factors that lead to a foot injury during physical activities are both high and low arched feet. Normally the medial longitudinal arch of the foot develops in the first 10 years of life, so flexible flat foot has an inversely relationship with age in the first decade, all over the world, the prevalence of flat foot is increasing. In approximately 15% of foot deformities cases, the deformity does not disappear and remains throughout adulthood, 90% of the clinical cases are complaining from foot problems are due to flatfoot. Flatfoot creates subtalar over pronation, which creates tibial and femoral medial rotation, and that is accompanied with increases of pelvic tilting anteriorly, which may influence the lumbar vertebrae alignment by increasing muscle tension and rotation. Objective: To study the impact of the flexible flatfoot on lumbosacral angle (angle of Ferguson). Methods: This experiment included 40 volunteers (14 females &26 males) gathered from the Faculty of Physical Therapy, Modern University of Technology and Information, Cairo, Egypt, for each participant, four angles were measured in the foot( talar first metatarsal angle, lateral talocalcaneal angle, , Calcaneal first metatarsal angle, calcaneal inclination angle) and one angle in the lumbar region (lumbosacral angle). Measurement of these angles was conducted by using Surgimap Spine software (version 2.2.9.6). Results: The results demonstrated that there was no significant correlation betweenFerguson angle and lateral talocalcaneal (r=0.164, p=0.313). Also, there was no significant correlation between Ferguson angle and talo first metatarsal “Meary’s angle" (r=0.007, p=0.968). Moreover, there was no significant correlation between Ferguson angle and calcaneal-first metatarsal angle (r=0.083, p=0.612). Also, there was no significant correlation between Ferguson angle and calcaneal inclination angle (r= 0.032, p= 0.846). Conclusion: It can be concluded that there is no significant correlation between the flexible flat foot and lumbosacral angle So, more study should be conducted in large sample and different ages and conditions of foot problems.

Keywords: calcaneal first metatarsal, calcaneal inclination, flatfoot, ferguson’s angle, lateral talocalcaneal angle, lumbosacral angle, and talar first metatarsal angle

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Authors: Cajethan U. Ugwuoke

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Agriculture is taught in secondary schools to develop skills in students which will empower them to contribute to national economic development. Unfortunately, our educational system emphasizes the application of conventional teaching methods in delivering instructions, which fails to produce students competent enough to carry out agricultural production. This study was therefore aimed at examining the application of digital technologies as tools for transformative instructional delivery. Four specific purposes, research questions and hypotheses guided the study. The study adopted a descriptive survey research design where 80 subjects representing 64 teachers of agriculture and 16 principals in the Udenu local government area of Enugu State, Nigeria, participated in the study. A structured questionnaire was used to collect data. The assumption of normality was ascertained by subjecting the data collected to a normality test. Data collected were later subjected to mean, Pearson product-moment correlation, ANOVA and t-test to answer the research questions and test the hypotheses at a 5% significant level. The result shows that the application of digital technologies helps to reduce learners’ boredom (3.52.75), improves learners’ performance (3.63.51), and is used as a visual aid for learners (3.56.61), among others. There was a positive, strong and significant relationship between the application of digital technologies and effective instructional delivery (+.895, p=.001<.05, F=17.73), competency of teachers to the application of digital technologies and effective instructional delivery (+998, p=.001<0.5, F=16263.45), and frequency of the application of digital technologies and effective instructional delivery (+.999, p=.001<.05, F=31436.14). There was no evidence of autocorrelation and multicollinearity in the regression models between the application of digital technologies and effective instructional delivery (2.03, Tolerance=1.00, VIF=1.00), competency of teachers in the application of digital technologies and effective instructional delivery (2.38, Tolerance=1.00, VIF=1.00) and frequency of the application of digital technologies and effective instructional delivery (2.00, Tolerance=1.00, VIF=1.00). Digital technologies should be therefore applied in teaching to facilitate effective instructional delivery in agriculture.

Keywords: agricultural science, digital technologies, instructional delivery, learning

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Authors: Anastasia Papachristou, Anastasia Ntikoudi, Vasileios Saridakis

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The safety and health care needs of refugees have become an increasingly important issue all over the world especially during last few decades. Wars are the primary reason for refugees to leave their countries. Moreover, refugees are frequently exposed to a variety of stressors such as socioeconomic disadvantages, poverty, changes in family structure and functioning, losing social support, difficulty to access education, living in very crowded places, experiencing racism and isolation. This systematic review included research studies published between 2007-2017 from the search databases Medline, Scopus, Cinahl and PubMed, with keywords 'war survivors', 'war trauma', 'psychiatric disorders', 'refugees'. In order to meet the purpose of the systematic review, further research for complementary studies was conducted into the literature references of the research articles included in this study that would meet the criteria. Overall, 14 studies were reviewed and evaluated. The majority of them demonstrated that the most common psychiatric disorders observed among war refugees are post-traumatic stress disorder (PTSD), depression, anxiety and multiple somatic complaints. Moreover, significant relationship was shown between the number of traumatic events experienced by the refugees and sociodemographic features such as gender, age and previous family history of any psychological disorder. War violence is highly traumatic, causing multiple, long-term negative outcomes such as the aforementioned psychiatric disorders. The number of the studies reviewed in this systematic review is not representative of the problem and its significance. The need for care of the survivors and their families is vital. Further research is necessary in order to clarify the role of predictive factors in the development and maintenance of post-traumatic stress and the rest psychiatric disorders following war trauma. In conclusion, it is necessary to have large multicenter studies in the future in order to be able to draw reliable conclusions about the effects of war.

Keywords: psychiatric disorders, refugees, war survivors, war trauma

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Authors: Mahnaz Motamedi, Mohammad Shahbazi, Shahrzad Rahimi-Naghani, Mehrdad Salehi

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Introduction and Aim: This study assessed sexual behaviours among men and women aged 15 to 49 years in Tehran. Material and Methods: This was a cross-sectional study conducted on 755 men and women aged 15 to 49 years who were residents of Tehran. To select the participants, a multistage, cluster, random sampling method was used and included different regions of Tehran. The data were collected using the WHO-endorsed Questionnaire of Sexual and Reproductive Health. Descriptive, bivariate, and multivariate analyses were conducted using SPSS version 20. Sexual and reproductive health (SRH) behaviours was a scale variable that was constructed from items of six sections: sexual experiences, characteristics of the first sexual partner, characteristics of the first intercourse, next sexual contact and the consequences of the first sexual contact, homosexual experiences and the causes of sexual abstinence. Results: The mean age at the time of sexual intercourse with penetration (vaginal, anal) was 19.88 in men and 21.82 in women. Multivariate analysis using linear regression showed that by controlling for other variables, gender had a significant relationship with having sexual experience, mean age of first sexual intercourse, and being multi-partner. Thus, women with sexual experience were 0.158 units less than men. The mean age of first intercourse in women was 1.57 units higher than men and being a multi-partner in women was 0.247 less than men (P < 0.001). Sexual experience in very religious and relatively religious individuals was 0.332 and 0.218 units less than those for whom religion did not matter (P < 0.001). 25.6% of men and 40.7% of women who did not have sexual experience at the time of the study stated that their reason for abstinence was their unwillingness to have sex (P < 0.05). 35.9% of men and 16.5% of women stated that the reason for abstinence was not providing a suitable opportunity (P < 0.001). 4.7% of men and 1.7% of women had sexual attraction to the same sex. The difference between men and women was significant (P < 0.001). Conclusion: Sexual relation is also present in singles and younger groups and is not limited to married or final marriage candidates. Therefore, more evaluation should be done in national research and interventions for sexual and reproductive health services should be done at the macro level of policy making.

Keywords: sexual behaviours, Iranian men and women, Iran, cross-sectional study

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Authors: Jieh-Jiuh Wang

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Disasters happen frequently due to the global climate changes today. The cultural heritage conservation should be considered from the perspectives of surrounding environments and large-scale disasters. Most current thoughts about the disaster prevention of cultural heritages in Taiwan are single-point thoughts emphasizing firefighting, decay prevention, and construction reinforcement and ignoring the whole concept of the environment. The traditional conservation cannot defend against more and more tremendous and frequent natural disasters caused by climate changes. More and more cultural heritages are confronting the high risk of disasters. This study adopts the perspective of risk identification and takes flood as the main disaster category. It analyzes the amount and categories of cultural heritages that might suffer from disasters with the geographic information system integrating the latest flooding potential data from National Fire Agency and Water Resources Agency and the basic data of cultural heritages. It examines the actual risk of cultural heritages confronting floods and serves as the accordance for future considerations of risk measures and preparation for reducing disasters. The result of the study finds the positive relationship between the disaster affected situation of national cultural heritages and the rainfall intensity. The order of impacted level by floods is historical buildings, historical sites indicated by municipalities and counties, and national historical sites and relics. However, traditional settlements and cultural landscapes are not impacted. It might be related to the taboo space in the traditional culture of site selection (concepts of disaster avoidance). As for the regional distribution on the other hand, cultural heritages in central and northern Taiwan suffer from more shocking floods, while the heritages in northern and eastern Taiwan suffer from more serious flooding depth.

Keywords: cultural heritage, flood, preventive conservation, risk management

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Authors: Wenyang Wan

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The study of urban land use and landscape pattern is the current hotspot in the fields of planning and design, ecology, etc., which is of great significance for the construction of the overall humanistic ecosystem of the city and optimization of the urban spatial structure. Banan District, as the main part of the eastern eco-city planning of Chongqing Municipality, is a high ground for highlighting the ecological characteristics of Chongqing, realizing effective transformation of ecological value, and promoting the integrated development of urban and rural areas. The analytical methods of land use transfer matrix (GIS) and landscape pattern index (Fragstats) were used to study the characteristics and laws of the evolution of land use landscape pattern in Banan District from 2000 to 2020, which provide some reference value for Banan District to alleviate the ecological contradiction of landscape. The results of the study show that ① Banan District is rich in land use types, of which the area of cultivated land will still account for 57.15% of the total area of the landscape until 2020, accounting for an absolute advantage in land use structure of Banan District; ② From 2000 to 2020, land use conversion in Banan District is characterized as Cropland > woodland > grassland > shrubland > built-up land > water bodies > wetlands, with cropland converted to built-up land being the largest; ③ From 2000 to 2020, the landscape elements of Banan District were distributed in a balanced way, and the landscape types were rich and diversified, but due to the influence of human interference, it also presented the characteristics that the shape of the landscape elements tended to be irregular, and the dominant patches were distributed in a scattered manner, and the patches had poor connectivity. It is recommended that in future regional ecological construction, the layout should be rationally optimized, the relationship between landscape components should be coordinated, the connectivity between landscape patches should be strengthened, and the degree of landscape fragmentation should be reduced.

Keywords: land use transfer, landscape pattern evolution, GIS and Fragstats, Banan district

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Authors: Amalia Ardeljan, Lexi Frankel, Divesh Manjani, Gabriela Santizo, Maximillian Guerra, Omar Rashid

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Introduction: Cytomegalovirus (CMV) infection is a widespread infection affecting between 60-70% of people in industrialized countries. CMV has been previously correlated with a higher incidence of Hodgkin Lymphoma compared to noninfected persons. Research regarding prior CMV infection and subsequent lymphoma development is still controversial. With limited evidence, further research is needed in order to understand the relationship between previous CMV infection and subsequent lymphoma development. This study assessed the effect of CMV infection and the incidence of lymphoma afterward. Methods: A retrospective cohort study (2010-2019) was conducted through a Health Insurance Portability and Accountability Act (HIPAA) compliant national database and conducted using International Classification of Disease (ICD) 9th,10th codes, and Current Procedural Terminology (CPT) codes. These were used to identify lymphoma diagnosis in a previously CMV infected population. Patients were matched for age range and Charlson Comorbidity Index (CCI). A chi-squared test was used to assess statistical significance. Results: A total number of 14,303 patients was obtained in the CMV infected group as well as in the control population (matched by age range and CCI score). Subsequent lymphoma development was seen at a rate of 11.44% (1,637) in the CMV group and 5.74% (822) in the control group, respectively. The difference was statistically significant by p= 2.2x10-16, odds ratio = 2.696 (95% CI 2.483- 2.927). In an attempt to stratify the population by antiviral medication exposure, the outcomes were limited by the decreased number of members exposed to antiviral medication in the control population. Conclusion: This study shows a statistically significant correlation between prior CMV infection and an increased incidence of lymphoma afterward. Further exploration is needed to identify the potential carcinogenic mechanism of CMV and whether the results are attributed to a confounding bias.

Keywords: cytomegalovirus, lymphoma, cancer, microbiology

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Authors: Sally Kafelghazal

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Introduction: Arab Americans, who include immigrants, refugees, or U.S. born persons of Middle Eastern or North African descent, may experience significant difficulties during acculturation to Western society. Influential stressors include relocation, loss of social support, language barriers, and economic factors, all of which can impact mental health. There is limited research investigating the effects of acculturation on the mental health of the Arab American population. Objectives: The purpose of this study is to identify ways in which acculturation impacts the mental health of Arab Americans, specifically the development of depression and anxiety. Method: A literature search was conducted using PubMed and PsycArticles (ProQuest), utilizing the following search terms: “Arab Americans,” “Arabs,” “mental health,” “depression,” “anxiety,” “acculturation.” Thirty-nine articles were identified and of those, nine specifically investigated the relationship between acculturation and mental health in Arab Americans. Three of the nine focused exclusively on depression. Results: Several risk factors were identified that contribute to poor mental health associated with acculturation, which include immigrant or refugee status, facing discrimination, and religious ideology. Protective factors include greater levels of acculturation, being U.S. born, and greater heritage identity. Greater mental health disorders were identified in Arab Americans compared to normative samples, perhaps particularly depression; none of the articles specifically addressed anxiety. Conclusion: The current research findings support the potential association between the process of acculturation and greater levels of mental health disorders in Arab Americans. However, the diversity of the Arab American population makes it difficult to draw consistent conclusions. Further research needs to be conducted in order to assess which subgroups in the Arab American population are at highest risk for developing new or exacerbating existing mental health disorders in order to devise more effective interventions.

Keywords: arab americans, arabs, mental health, anxiety, depression, acculturation

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Authors: R.T.P. De Silva, T. K. Wijayasiriwardhane, B. Jayawardena

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Most people nowadays spend their time indoor environment. Because of that, a quality indoor environment needs for them. This study was conducted to identify how to improve indoor visual comfort using a personalized light system. Light intensity, light color, glare, and contrast are the main facts that affect visual comfort. The light intensity which needs to perform a task is changed according to the task. Using necessary light intensity and we can improve the visual comfort of occupants. The hue can affect the emotions of occupants. The preferred light colors and intensity change according to the occupant's age and gender. The research was conducted to identify is there any relationship between personalization and visual comfort. To validate this designed an Internet of Things-based reading light. This light can work according to the standard light levels and personalized light levels. It also can measure the current light intensity of the environment and maintain continuous light levels according to the task. The test was conducted by using 25 undergraduates, and 5school students, and 5 adults. The feedbacks are gathered using Post-occupancy evaluation (POE) techniques. Feedbacks are gathered in three steps, It was done without any light control, with standard light level, and with personalized light level Users had to spend 10 minutes under each condition. After finishing each step, collected their feedbacks. According to the result gathered, 94% of participants rated a personalized light system as comfort for them. The feedbacks show stay under continuous light level help to keep their concentrate. Future research can be conducted on how the color of indoor light can affect for indoor visual comfort of occupants using a personalized light system. Further proposed IoT based can improve to change the light colors according to the user's preference.

Keywords: indoor environment quality, internet of things based light system, post occupancy evaluation, visual comfort

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Authors: Kayode Ilesanmi Ebenezer Bowale, Dominic Azuh, Busayo Aderounmu, Alfred Ilesanmi

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There has been a debate among scholars and policymakers about the effects of oil exploration and production on industrial development. In Nigeria, there were many reforms resulting in an increase in crude oil production in the recent past. There is a controversy on the importance of oil production in the development of the manufacturing sector in Nigeria. Some scholars claim that oil has been a blessing to the development of the manufacturing sector, while others regard it as a curse. The objective of the study is to determine if empirical analysis supports the presence of Dutch Disease and de-industrialisation in the Nigerian manufacturing sector between 2019- 2022. The study employed data that were sourced from World Development Indicators, Nigeria Bureau of Statistics, and the Central Bank of Nigeria Statistical Bulletin on manufactured exports, manufacturing employment, agricultural employment, and service employment in line with the theory of Dutch Disease using the unit root test to establish their level of stationarity, Engel and Granger cointegration test to check their long-run relationship. Autoregressive. Distributed Lagged bound test was also used. The Vector Error Correction Model will be carried out to determine the speed of adjustment of the manufacturing export and resource movement effect. The results showed that the Nigerian manufacturing industry suffered from both direct and indirect de-industrialisation over the period. The findings also revealed that there was resource movement as labour moved away from the manufacturing sector to both the oil sector and the services sector. The study concluded that there was the presence of Dutch Disease in the manufacturing industry, and the problem of de-industrialisation led to the crowding out of manufacturing output. The study recommends that efforts should be made to diversify the Nigerian economy. Furthermore, a conducive business environment should be provided to encourage more involvement of the private sector in the agriculture and manufacturing sectors of the economy.

Keywords: Dutch disease, resource movement, manufacturing sector performance, Nigeria

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Authors: Azar Heidarizadi, Mahdieh Salimi, Hossein Mozdarani

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Introduction: As a complex disease, breast cancer results from several genetic and epigenetic changes. Lactoferrin, a member of the transferrin family, is reported to have a number of biological functions, including DNA synthesis, immune responses, iron transport, etc., any of which could play a role in tumor progression. The aim of this study was to investigate the bioinformatics data and experimental assay to find the pattern of promoter methylation and gene expression of LTF in breast cancer in order to study its potential role in cancer management. Material and Methods: In order to evaluate the methylation status of the LTF promoter, we studied the MS-PCR and Real-Time PCR on samples from patients with breast cancer and normal cases. 67 patient samples were conducted for this study, including tumoral, plasma, and normal tissue adjacent samples, as well as 30 plasma from normal cases and 10 tissue breast reduction cases. Subsequently, bioinformatics analyses such as cBioPortal databases, string, and genomatix were conducted to disclose the prognostic value of LTF in breast cancer progression. Results: The analysis of LTF expression showed an inverse relationship between the expression level of LTF and the stages of tissues of breast cancer patients (p<0.01). In fact, stages 1 and 2 had a high expression in LTF, while, in stages 3 and 4, a significant reduction was observable (p < 0.0001). LTF expression frequently alters with a decrease in the expression in ER⁺, PR⁺, and HER2⁺ patients (P < 0.01) and an increase in the expression in the TNBC, LN¯, ER¯, and PR- patients (P < 0.001). Also, LTF expression is significantly associated with metastasis and lymph node involvement factors (P < 0.0001). The sensitivity and specificity of LTF were detected, respectively. A negative correlation was detected between the results of level expression and methylation of the LTF promoter. Conclusions: The altered expression of LTF observed in breast cancer patients could be considered as a promotion in cell proliferation and metastasis even in the early stages of cancer.

Keywords: LTF, expression, methylation, breast cancer

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