Search results for: Wi-Fi library

Authors: Ma'in Abushaikha

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Memorials are usually a landmark could be either an object, sculpture or a statue. They are built for a specific group or person who has died with historical contribution, or it could refer to an important hub, event or a specific culture, therefore to keep past events alive in the common memory through this kind of physical representation in public areas, or even to satisfy the desire to honour something either it is a person who suffered or died during a conflict or just to honour a group of people or even a whole society in a specific character they used to possess during a specific period of time. The aim behind the research is to look more deeply about the importance of memorials placement and environment for more successful outcomes towards people's psychology, therefore, behavior, manners and characteristics, knowing that in the main, they are usually set for function able purposes so people could be involved meaningfully therefore psychologically more than aesthetically. What contribution either positive or negative does memorialization through its physical/urban elements has towards people? Is it towards locals social reconstruction over time including either their understanding to the current conflicts or is it toward their general behavior, manners and characteristics in terms of psychology? And how important Memorial's placement is for the observer? Moreover, how does that either reduces or increases its value, attractiveness, and its effectiveness? This paper considers taking north Cyprus memorials as the main case study, is good enough as a choice to support the research hypothesis where a comparison between deferent memorials is going to be done as the main approach in trying to address the mentioned questions, by that, the research requires field survey in terms of interviewing both dwellers and general observers as well as library survey by viewing similar studies. As a significant result, this research is about to come up assesses how important memorials placements are, in order to apply its impact to the observers, whereas the most successful placed ones have its more effectiveness on observers psychology by time by introducing several mental reflects by this kind of physical representation.

Keywords: memorials, placement, environment, impact, psychology, characteristics, manners, behavior

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Authors: Michael Moeti, Khuliso Sigama, Thapelo Samuel Matlala

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One of the principal challenges that the world is confronted with is insecurity. The crime rate is increasing exponentially, and protecting our physical assets especially in the motorist industry, is becoming impossible when applying our own strength. The need to develop technological solutions that detect and report theft without any human interference is inevitable. This is critical, especially for vehicle owners, to ensure theft detection and speedy identification towards recovery efforts in cases where a vehicle is missing or attempted theft is taking place. The vehicle theft detection system uses Convolutional Neural Network (CNN) to recognize the driver's face captured using an installed mobile phone device. The location identification function uses a Global Positioning System (GPS) to determine the real-time location of the vehicle. Upon identification of the location, Global System for Mobile Communications (GSM) technology is used to report or notify the vehicle owner about the whereabouts of the vehicle. The installed mobile app was implemented by making use of python as it is undoubtedly the best choice in machine learning. It allows easy access to machine learning algorithms through its widely developed library ecosystem. The graphical user interface was developed by making use of JAVA as it is better suited for mobile development. Google's online database (Firebase) was used as a means of storage for the application. The system integration test was performed using a simple percentage analysis. Sixty (60) vehicle owners participated in this study as a sample, and questionnaires were used in order to establish the acceptability of the system developed. The result indicates the efficiency of the proposed system, and consequently, the paper proposes the use of the system can effectively monitor the vehicle at any given place, even if it is driven outside its normal jurisdiction. More so, the system can be used as a database to detect, locate and report missing vehicles to different security agencies.

Keywords: CNN, location identification, tracking, GPS, GSM

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Authors: Iman Shabanzadeh

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In terms of its geopolitical position, Iran has been one of the main centers of migration movements in the world in recent decades. However, the policy makers' lack of preparation in completing the cycle of social integration of these immigrants, especially the second and third generation, has caused these people to always be prone to leave the country and immigrate to developed and industrialized countries. In this research, the issue of integration of immigrants in Iran from the perspective of four indicators, "Identity Documents", "Access to Banking Services", "Access to Health and Treatment Services" and "Obtaining a Driver's License" will be analyzed. The research method is descriptive-analytical. To collect information, library and document sources in the field of laws and regulations related to immigrants' rights in Iran, semi-structured interviews with experts have been used. The investigations of this study show that none of the residence documents of immigrants in Iran guarantee the full enjoyment of basic citizenship rights for them. In fact, the function of many of these identity documents, such as the census card, educational support card, etc., is only to prevent crossing the border, and none of them guarantee the basic rights of citizenship. Therefore, for many immigrants, the difference between legality and illegality is only in the risk of crossing the border, and this has led to the spread of the habit of illegal presence for them. Despite this, it seems that there is no clear and coherent policy framework around the issue of foreign immigrants in the country. This policy incoherence can be clearly seen in the diversity and plurality of identity and legal documents of the citizens present in the country and the policy maker's lack of planning to integrate and organize the identity of this huge group. Examining the differences and socioeconomic inequalities between immigrants and the native Iranian population shows that immigrants have been poorly integrated into the structures of Iranian society from an economic and social point of view.

Keywords: immigrants, social integration, citizen services, structural inequality

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Authors: Murali Aarthy, Sanjeev Kumar Singh

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High risk human papillomaviruses are highly associated with the carcinoma of the cervix and the other genital tumors. Cervical cancer develops through the multistep process in which increasingly severe premalignant dysplastic lesions called cervical intraepithelial neoplastic progress to invasive cancer. The oncoprotein E7 of human papillomavirus expressed in the lower epithelial layers drives the cells into S-phase creating an environment conducive for viral genome replication and cell proliferation. The replication of the virus occurs in the terminally differentiating epithelium and requires the activation of cellular DNA replication proteins. To date, no suitable drug molecule is available to treat HPV infection whereas identification of potential drug targets and development of novel anti-HPV chemotherapies with unique mode of actions are expected. Hence, our present study aimed to identify the potential inhibitors analogous to EGCG, a green tea molecule which is considered to be safe to use for mammalian systems. A 3D similarity search on the natural small molecule library from natural product database using EGCG identified 11 potential hits based on their similarity score. The structure based docking strategies were implemented in the potential hits and the key interacting residues of protein with compounds were identified through simulation studies and binding free energy calculations. The conformational changes between the apoprotein and the complex were analyzed with the simulation and the results demonstrated that the dynamical and structural effects observed in the protein were induced by the compounds and indicated the dominance to the oncoprotein. Overall, our study provides the basis for the structural insights of the identified potential hits and EGCG and hence, the analogous compounds identified can be potent inhibitors against the HPV 16 E7 oncoprotein.

Keywords: EGCG, oncoprotein, molecular dynamics simulation, analogues

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Authors: Tomas Premoli, Sareh Rowlands

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In this study, we investigate the impact of various convolutional neural network (CNN) architectures on the accuracy of diagnosing Alzheimer’s disease (AD) using patient MRI scans. Alzheimer’s disease is a debilitating neurodegenerative disorder that affects millions worldwide. Early, accurate, and non-invasive diagnostic methods are required for providing optimal care and symptom management. Deep learning techniques, particularly CNNs, have shown great promise in enhancing this diagnostic process. We aim to contribute to the ongoing research in this field by comparing the effectiveness of different CNN architectures and providing insights for future studies. Our methodology involved preprocessing MRI data, implementing multiple CNN architectures, and evaluating the performance of each model. We employed intensity normalization, linear registration, and skull stripping for our preprocessing. The selected architectures included VGG, ResNet, and DenseNet models, all implemented using the Keras library. We employed transfer learning and trained models from scratch to compare their effectiveness. Our findings demonstrated significant differences in performance among the tested architectures, with DenseNet201 achieving the highest accuracy of 86.4%. Transfer learning proved to be helpful in improving model performance. We also identified potential areas for future research, such as experimenting with other architectures, optimizing hyperparameters, and employing fine-tuning strategies. By providing a comprehensive analysis of the selected CNN architectures, we offer a solid foundation for future research in Alzheimer’s disease diagnosis using deep learning techniques. Our study highlights the potential of CNNs as a valuable diagnostic tool and emphasizes the importance of ongoing research to develop more accurate and effective models.

Keywords: Alzheimer’s disease, convolutional neural networks, deep learning, medical imaging, MRI

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Authors: Maatouk Mohamed, Nouira Mariem, Hamdi Kbir Gh, Mahjoubi M. F., Ben Moussa M.

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Background and aim: Preoperative biliary drainage (PBD) has been introduced to lower bilirubin levels and to control the negative effects of obstructive jaundice in patients with malignant obstructive jaundice undergoing pancreaticoduodenectomy (PD). The optimal time interval between PBD and PD is still not clear. Delaying surgery by 4 to 6 weeks is the commonly accepted practice. However, delayed PD has been shown to decrease the rate of resection and adversely affect the tumor grading and prognosis. Thus, the purpose of our systematic review and meta-analysis was to evaluate the optimal period for PBD prior to PD: short or prolonged in terms of postoperative morbidity and survival outcomes. Methods: Trials were searched in PubMed, Science Direct, Google Scholar, and Cochrane Library until November 2022. Studies using PBD in patients with malignant obstructive jaundice that compared short duration group (SDG) (surgery performed within 3-4 weeks) with prolonged duration group (PDG) (at least 3-4 weeks after PBD) were included in this study. The risk of bias was assessed using the Rob v2 and Robins-I tools. The priori protocol was published in PROSPERO (ID: CRD42022381405). Results: Seven studies comprising 1625 patients (SDG 870, PDG 882) were included. All studies were non-randomized, and only one was prospective. No significant differences were observed between the SDG and PDG in mortality (OR= 0.59; 95% CI [0.30, 1.17], p=0.13), major morbidity (Chi² = 30.28, p <0.00001; I² = 87%), pancreatic fistula (Chi² = 6.61, p = 0.25); I² = 24%), post pancreatectomy haemorrhage (OR= 1.16; 95% CI [0.67, 2.01], p=0.59), positive drainage culture (OR= 0.36; 95% CI [0.10, 1.32], p=0.12), septic complications (OR= 0.78; 95% CI [0.23, 2.72], p=0.70), wound infection (OR= 0.08, p=0.07), operative time (MD= 0.21; p=0.21). Conclusion: Early surgery within 3 or 4 weeks after biliary drainage is both safe and effective. Thus, it is reasonable to suggest early surgery following PBD for patients having resectable periampullary cancers.

Keywords: preoperative biliary drainage, pancreatic cancer, pancreatic surgery, complication

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Authors: Daniela V. Bavaresco, Tamy Colonetti, Antonio Jose Grande, Francesc Colom, Joao Quevedo, Samira S. Valvassori, Maria Ines da Rosa

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Objective: Performed a systematic review and meta-analysis to evaluated the potential effect of the cyclo-oxygenases (Cox)-2 inhibitor Celecoxib adjunct treatment in Bipolar Disorder (BD), through of randomized controlled trials. Method: A search of the electronic databases was proceeded, on MEDLINE, EMBASE, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), Biomed Central, Web of Science, IBECS, LILACS, PsycINFO (American Psychological Association), Congress Abstracts, and Grey literature (Google Scholar and the British Library) for studies published from January 1990 to February 2018. A search strategy was developed using the terms: 'Bipolar disorder' or 'Bipolar mania' or 'Bipolar depression' or 'Bipolar mixed' or 'Bipolar euthymic' and 'Celecoxib' or 'Cyclooxygenase-2 inhibitors' or 'Cox-2 inhibitors' as text words and Medical Subject Headings (i.e., MeSH and EMTREE) and searched. The therapeutic effects of adjunctive treatment with Celecoxib were analyzed, it was possible to carry out a meta-analysis of three studies included in the systematic review. The meta-analysis was performed including the final results of the Young Mania Rating Scale (YMRS) at the end of randomized controlled trials (RCT). Results: Three primary studies were included in the systematic review, with a total of 121 patients. The meta-analysis had significant effect in the YMRS scores from patients with BD who used Celecoxib adjuvant treatment in comparison to placebo. The weighted mean difference was 5.54 (95%CI=3.26-7.82); p < 0.001; I2 =0%). Conclusion: The systematic review suggests that adjuvant treatment with Celecoxib improves the response of major treatments in patients with BD when compared with adjuvant placebo treatment.

Keywords: bipolar disorder, Cox-2 inhibitors, Celecoxib, systematic review, meta-analysis

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Authors: Anika Chebrolu

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Mono-targeted drugs can be of limited efficacy against complex diseases. Recently, multi-target drug design has been approached as a promising tool to fight against these challenging diseases. However, the scope of current computational approaches for multi-target drug design is limited. DeepLig presents a de-novo drug discovery platform that uses reinforcement learning to generate and optimize novel, potent, and multitargeted drug candidates against protein targets. DeepLig’s model consists of two networks in interplay: a generative network and a predictive network. The generative network, a Stack- Augmented Recurrent Neural Network, utilizes a stack memory unit to remember and recognize molecular patterns when generating novel ligands from scratch. The generative network passes each newly created ligand to the predictive network, which then uses multiple Graph Attention Networks simultaneously to forecast the average binding affinity of the generated ligand towards multiple target proteins. With each iteration, given feedback from the predictive network, the generative network learns to optimize itself to create molecules with a higher average binding affinity towards multiple proteins. DeepLig was evaluated based on its ability to generate multi-target ligands against two distinct proteins, multi-target ligands against three distinct proteins, and multi-target ligands against two distinct binding pockets on the same protein. With each test case, DeepLig was able to create a library of valid, synthetically accessible, and novel molecules with optimal and equipotent binding energies. We propose that DeepLig provides an effective approach to design multi-targeted drug therapies that can potentially show higher success rates during in-vitro trials.

Keywords: drug design, multitargeticity, de-novo, reinforcement learning

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Authors: Mahalingam Palaniandi

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Higher education plays vital role in the nation building process for a country and the rest of world. The higher education sector develops the change-agents for the various fields which will help the human-kind wheel to run further. Conventional and traditional class-room based learning and teaching was followed in many decades which is one-to-one and one-to-many. In a way, these are simplest form of learners to be assembled in a class room wherein the teacher used the blackboard to demonstrate the theory and laboratories used for practical. As the technology evolved tremendously for the last 40 years, the teaching and learning environment changed slowly, wherein, the learning community will be anywhere in the world and teacher deliver the content through internet based tools such as video conferencing, web based conferencing tools or E-learning platforms such as Blackboard or noodle. Present day, the mobile technologies plays an important tool to deliver the teaching content on-the-go. Both PC based and mobile based learning technology brought the learning and teaching community together in various aspects. However, as the learning technology also brought various hurdles for learning processes such as plagiarism and not using the reference books entirely as most of the students wants the information instantaneously using internet without actually going to the library to take the notes from the millions of the books which are not available online as e-books which result lack of fundamental knowledge of the concepts complex theories. However, technology is inseparable in human life, now-a-days and every part of it contains piece of information technology right from computers to home appliances. To make use of the IT based learning and teaching at most efficiency, we should have a proper framework and recommendations laid to the learning community in order to derive the maximum efficiency from the IT based teaching and leaning. This paper discusses various IT based tools available for the learning community, efficiency from its usage and recommendations for the suitable framework that needs to be implemented at higher education institutions which makes the learners stronger in both theory as well as real-time knowledge of their studies that is going to be used in their future for the better world.

Keywords: higher education, e-learning, teaching learning, eLearning tools

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Authors: Ana Lucia Molina

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Introduction: Fine motor skills refer to the use of the hands and coordination of the small muscles that control the fingers. A deficiency in fine motor skills is as important as a change in global movements, as fine motor skills directly affect activities of daily living. Fine movements are involved in some functions, such as motor control of the extremities, sensitivity, strength and tonus of the hands. A growing interest in the effects of non-invasive neuromodulation, such as transcranial stimulation technologies, through transcranial magnetic stimulation (TMS), has been observed in the scientific literature, with promising results in fine motor rehabilitation, as it provides modulation of the corresponding cortical activity in the area primary motor skills of the hands in both hemispheres (according to the International System 10-20, corresponding to C3 and C4). Objectives: to carry out a literature review about the effects of TMS on the cortical motor area corresponding to hand motricity. Methodology: This is a bibliographic survey carried out between October 2022 and March 2023 at Pubmed, Google Scholar, Lillacs and Virtual Health Library (BVS), with a national and international database. Some books on neuromodulation were included. Results: 28 articles and 5 books were initially found, and after reading the abstracts, only 14 articles and 3 books were selected, with publication dates between 2008 and 2022, to compose the literature review since it suited the purpose of this study. Conclusion: TMS has shown promising results in the treatment of fine motor rehabilitation, such as improving coordination, muscle strength and range of motion of the hands, being a complementary technique to existing treatments and thus providing more potent results for manual skills in activities of daily living. It is important to emphasize the need for more specific studies on the application of TMS for the treatment of manual disorders, which describe the uniqueness of each movement.

Keywords: transcranial magnetic stimulation, fine motor skills, motor rehabilitation, non-invasive neuromodulation

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Authors: Hushyar Azari

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Aim and background: Deep brain stimulation (DBS) is regarded as an important therapeutic choice for Parkinson's disease (PD). The two most common targets for DBS are the subthalamic nucleus (STN) and globus pallidus (GPi). This review was conducted to compare the clinical effectiveness of these two targets. Methods: A systematic literature search in electronic databases: Embase, Cochrane Library and PubMed were restricted to English language publications 2010 to 2021. Specified MeSH terms were searched in all databases. Studies which evaluated the Unified Parkinson's Disease Rating Scale (UPDRS) III were selected by meeting the following criteria: (1) compared both GPi and STN DBS; (2) had at least three months follow-up period; (3)at least five participants in each group; (4)conducted after 2010. Study quality assessment was performed using the Modified Jadad Scale. Results: 3577 potentially relevant articles were identified, of these, 3569 were excluded based on title and abstract, duplicate and unsuitable article removal. Eight articles satisfied the inclusion criteria and were scrutinized (458 PD patients). According to Modified Jadad Scale, the majority of included studies had low evidence quality which was a limitation of this review. 5 studies reported no statistically significant between-group difference for improvements in UPDRS ш scores. At the same time, there were some results in terms of pain, action tremor, rigidity, and urinary symptoms, which indicated that STN DBS might be a better choice. Regarding the adverse effects, GPi was superior. Conclusion: It is clear that other larger randomized clinical trials with longer follow-up periods and control groups are needed to decide which target is more efficient for deep brain stimulation in Parkinson’s disease and imposes fewer adverse effects on the patients. Meanwhile, STN seems more reasonable according to the results of this systematic review.

Keywords: brain stimulation, globus pallidus, Parkinson's disease, subthalamic nucleus

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Authors: A. M. John-Otumu, M. M. Rahman, O. C. Nwokonkwo, M. C. Onuoha

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Online social media networks have long served as a primary arena for group conversations, gossip, text-based information sharing and distribution. The use of natural language processing techniques for text classification and unbiased decision-making has not been far-fetched. Proper classification of this textual information in a given context has also been very difficult. As a result, we decided to conduct a systematic review of previous literature on sentiment classification and AI-based techniques that have been used in order to gain a better understanding of the process of designing and developing a robust and more accurate sentiment classifier that can correctly classify social media textual information of a given context between hate speech and inverted compliments with a high level of accuracy by assessing different artificial intelligence techniques. We evaluated over 250 articles from digital sources like ScienceDirect, ACM, Google Scholar, and IEEE Xplore and whittled down the number of research to 31. Findings revealed that Deep learning approaches such as CNN, RNN, BERT, and LSTM outperformed various machine learning techniques in terms of performance accuracy. A large dataset is also necessary for developing a robust sentiment classifier and can be obtained from places like Twitter, movie reviews, Kaggle, SST, and SemEval Task4. Hybrid Deep Learning techniques like CNN+LSTM, CNN+GRU, CNN+BERT outperformed single Deep Learning techniques and machine learning techniques. Python programming language outperformed Java programming language in terms of sentiment analyzer development due to its simplicity and AI-based library functionalities. Based on some of the important findings from this study, we made a recommendation for future research.

Keywords: artificial intelligence, natural language processing, sentiment analysis, social network, text

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Authors: Gülcan Taşkıran, Ayla Bayık Temel

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Background: Florence Nightingale, the modern founder of the nursing, is most famous for her role as a nurse. But not so much known about her contributions as a mathematician and statistician. Aim: In this conceptual article it is aimed to examine Florence Nightingale's statistics education, how she used her passion for statistics and applied statistical data in nursing care and her scientific contributions to statistical science. Design: Literature review method was used in the study. The databases of Istanbul University Library Search Engine, Turkish Medical Directory, Thesis Scanning Center of Higher Education Council, PubMed, Google Scholar, EBSCO Host, Web of Science were scanned to reach the studies. The keywords 'statistics' and 'Florence Nightingale' have been used in Turkish and English while being screened. As a result of the screening, totally 41 studies were examined from the national and international literature. Results: Florence Nightingale has interested in mathematics and statistics at her early ages and has received various training in these subjects. Lessons learned by Nightingale in a cultured family environment, her talent in mathematics and numbers, and her religious beliefs played a crucial role in the direction of the statistics. She was influenced by Quetelet's ideas in the formation of the statistical philosophy and received support from William Farr in her statistical studies. During the Crimean War, she applied statistical knowledge to nursing care, developed many statistical methods and graphics, so that she made revolutionary reforms in the health field. Conclusions: Nightingale's interest in statistics, her broad vision, the statistical ideas fused with religious beliefs, the innovative graphics she has developed and the extraordinary statistical projects that she carried out has been influential on the basis of her professional achievements. Florence Nightingale has also become a model for women in statistics. Today, using and teaching of statistics and research in nursing care practices and education programs continues with the light she gave.

Keywords: Crimean war, Florence Nightingale, nursing, statistics

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Authors: Maya Saade, Rafic Younes, Pascal Lafon

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This paper explores the transformative impact of smartphones on pedagogy and presents a smartphone application developed specifically for engineering problem-solving and educational purposes. The widespread availability and advanced capabilities of smartphones have revolutionized the way we interact with technology, including in education. The ubiquity of smartphones allows learners to access educational resources anytime and anywhere, promoting personalized and self-directed learning. The first part of this paper discusses the overall influence of smartphones on pedagogy, emphasizing their potential to improve learning experiences through mobile technology. In the context of engineering education, this paper focuses on the development of a dedicated smartphone application that serves as a powerful tool for both engineering problem-solving and education. The application features an intuitive and user-friendly interface, allowing engineering students and professionals to perform complex calculations and analyses on their smartphones. The smartphone application primarily focuses on beam calculations and serves as a comprehensive beam calculator tailored to engineering education. It caters to various engineering disciplines by offering interactive modules that allow students to learn key concepts through hands-on activities and simulations. With a primary emphasis on beam analysis, this application empowers users to perform calculations for statically determinate beams, statically indeterminate beams, and beam buckling phenomena. Furthermore, the app includes a comprehensive library of engineering formulas and reference materials, facilitating a deeper understanding and practical application of the fundamental principles in beam analysis. By offering a wide range of features specifically tailored for beam calculation, this application provides an invaluable tool for engineering students and professionals looking to enhance their understanding and proficiency in this crucial aspect of a structural engineer.

Keywords: mobile devices in education, solving engineering problems, smartphone application, engineering education

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Authors: Denis Duagi, Ben Carter, Maria Farrelly, Stephen Lisk, June S. L. Brown

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Background: Adolescence represents a distinctive phase of development, and variables linked to this developmental period could affect the efficiency of prevention and treatment for depression and anxiety, as well as the long-term prognosis. The objectives of this study were to investigate the long-term effectiveness of psychosocial interventions for adolescents on depression and anxiety symptoms and to assess the influence of different intervention parameters on the long-term effects. Methods: Searches were carried out on the 11ᵗʰ of August 2022 using five databases (Cochrane Library, Embase, Medline, PsychInfo, Web of Science), as well as trial registers. Randomized controlled trials of psychosocial interventions targeting specifically adolescents were included if they assessed outcomes at 1-year post-intervention or more. The Cochrane risk of bias-2 quality assessment tool was used. The primary outcome was depression, and studies were pooled using a standardised mean difference, with an associated 95% confidence interval, p-value, and I². The study protocol was pre-registered (CRD42022348668). Findings: A total of 57 reports (n= 46,678 participants) were included in the review. Psychosocial interventions led to small reductions in depressive symptoms, with a standardised mean difference (SMD) at 1-year of -0.08 (95%CI -0.20, -0.03, p=0.002, I²=72%), 18-months SMD=-0.12, 95% CI -0.22, -0.01, p=0.03, I²=63%) and 2-years SMD=-0.12 (95% CI -0.20, -0.03, p=0.01, I²=68%). Sub-group analyses indicated that targeted interventions produced stronger effects, particularly when delivered by trained mental health professionals (K=18, SMD=-0.24, 95% CI -0.38, -0.10, p=0.001, I²=60%). No effects were detected for anxiety at any assessment. Conclusion: Psychosocial interventions specifically targeting adolescents were shown to have small but positive effects on depression symptoms but not anxiety symptoms, which were sustained for up to 2 years. These findings highlight the potential population-level preventive effects if such psychosocial interventions become widely implemented in accessible settings such as schools.

Keywords: psychosocial, adolescent, interventions, depression, anxiety, meta-analysis, randomized controlled trial

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Authors: Fabiha Tanzeem

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BACKGROUND: Osteoporosis is a skeletal disease that is associated with a reduction in bone mass and microstructures of the bone and deterioration of bone tissue. Fragility fracture due to osteoporosis is the most significant complication of osteoporosis. The increasing prevalence of fragility fractures presents a growing burden on the global economy. There is a rapidly evolving need to improve awareness of the costs associated with these types of fractures and to review current policies and practices for the prevention and management of the disease. This systematic review will identify and describe the direct and indirect costs associated with osteoporotic fragility fractures from a global perspective from the included studies. The review will also find out whether the costs required for the treatment of fragility fractures due to osteoporosis impose an economic burden on the global healthcare system. METHODS: Four major databases were systematically searched for direct and indirect costs of osteoporotic fragility fracture studies in the English Language. PubMed, Cochrane Library, Embase and Google Scholar were searched for suitable articles published between 1990 and July 2020. RESULTS: The original search yielded 1166 papers; from these, 27 articles were selected for this review according to the inclusion and exclusion criteria. In the 27 studies, the highest direct costs were associated with the treatment of pelvic fractures, with the majority of the expenditure due to hospitalization and surgical treatments. It is also observed that most of the articles are from developed countries. CONCLUSION: This review indicates the significance of the economic burden of osteoporosis globally, although more research needs to be done in developing countries. In the treatment of fragility fractures, direct costs were the main reported expenditure in this review. The healthcare costs incurred globally can be significantly reduced by implementing measures to effectively prevent the disease. Raising awareness in children and adults by improving the quality of the information available and standardising policies and planning of services requires further research.

Keywords: systematic review, osteoporosis, cost of illness

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Authors: Guillaume Richard, Sarra Zaied

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Marine waste quantities increase more and more, 5 million tons of plastic waste enter the ocean every year. Their spatiotemporal distribution is never homogeneous and depends mainly on the hydrodynamic characteristics of the environment, as well as the size and location of the waste. As part of optimizing collect of marine plastic wastes, it is important to measure and monitor their evolution over time. In this context, diverse studies have been dedicated to describing waste behavior in order to identify its accumulation in ocean areas. None of the existing tools which track objects at sea had the objective of tracking down a slick of waste. Moreover, the applications related to marine waste are in the minority compared to rescue applications or oil slicks tracking applications. These approaches are able to accurately simulate an object's behavior over time but not during the collection mission of a waste sheet. This paper presents numerical modeling of a boat’s wake impact on the floating marine waste behavior during a collection mission. The aim is to predict the trajectory of a marine waste slick to optimize its collection using meteorological data of ocean currents, wind, and possibly waves. We have made the choice to use Ocean Parcels which is a Python library suitable for trajectoring particles in the ocean. The modeling results showed the important role of advection and diffusion processes in the spatiotemporal distribution of floating plastic litter. The performance of the proposed method was evaluated on real data collected from the Copernicus Marine Environment Monitoring Service (CMEMS). The results of the evaluation in Cape of Good Hope (South Africa) prove that the proposed approach can effectively predict the position and velocity of marine litter during collection, which allowed for optimizing time and more than $90\%$ of the amount of collected waste.

Keywords: marine litter, advection-diffusion equation, sea current, numerical model

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Authors: Nuo Xu, Sijing Chen

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Background: Childbirth is considered a critical traumatic event throughout our lives, positively or negatively impacting the mother's physiology, psychology, and even the whole family. Adverse birth experiences, such as labor pain, anxiety, and fear can negatively impact the mother. Studies had shown that the immersive nature of VR can distract attention from pain and increase focus on interventions for pain relief. However, the existing studies that applied VR to maternal delivery were still in their infancy and showed disparate results, and the small sample size is not representative, so this review analyzed the effects of VR in labor, such as on maternal pain and anxiety, with a view to providing a basis for future applications. Search strategy: We searched Pubmed, Embase, Web of Science, the Cochrane Library, CINAHL, China National Knowledge Infrastructure, Wan-Fang database from the building to November 17, 2021. Selection Criteria: Randomized controlled trials (RCTs) that intervened the pregnant women aged 18-35 years with gestational >34 weeks and without complications with VR technology were contained within this review. Data Collection and Analysis: Two researchers completed the study selection, data extraction, and assessment of study quality. For quantitative data we used MD or SMD, and RR (risk ratio) for qualitative data. Random-effects model and 95% confidence interval (95% CI) were used. Main Results: 12 studies were included. Using VR could relieve pain during labor (MD=-1.81, 95% CI (-2.04, -1.57), P< 0.00001) and active period (SMD=-0.41, 95% CI (-0.68, -0.14), P= 0.003), reduce anxiety (SMD=-1.39, 95% CI (-1.99, -0.78), P< 0.00001) and improve satisfaction (RR = 1.32; 95% CI (1.10, 1.59); P = 0.003), but the effect on the duration of first (SMD=-1.12, 95% CI (-2.38, 0.13), P=0.08) and second (SMD=-0.22, 95% CI (-0.67, 0.24), P=0.35) stage of labor was not statistically significant. Conclusions: Compared with conventional care, VR technology can relieve labor pain and anxiety and improve satisfaction. However, extensive experimental validation is still needed.

Keywords: virtual reality, delivery, labor pain, anxiety, meta-analysis, systematic review

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Authors: Emrah Ayhan, Puspa Saananta Irfani, Ömer Doğukan Şahin

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Public services, which are important for the order and continuity of social life, have begun to transform into electronic services (E-service) with the development of information and communication technologies in recent years. In particular, as a result of the widespread use of the internet and the increase in citizen demands, it has become necessary to provide public services electronically. In addition to facilitating traditional public services, new types of e-services strengthen the interaction, cooperation, accessibility, transparency, citizen participation (e-governance) and accountability between citizens and the state. In this context, the factors in the literature that are considered to influence the citizens’ satisfaction towards e-services will be examined through the example of student satisfaction with the e-services (Anasis, Mergen, E-mail, library, cafeteria and other transactions) offered by Anadolu University (Eskişehir, Türkiye) through university website and mobile application. The data for the analysis will be obtained from the survey research that will be used to measure user satisfaction with university e-services of 1,000 students studying at 9 different faculties and graduate schools of Anadolu University. These data will be analyzed with a unique methodology that uses the E-GovQual model and Importance Performance Analysis (IPA) methods together. The e-GovQual model serves as a framework for evaluating the quality of e-services, allowing a detailed understanding of students' perceptions. On the other hand, the IPA method will be used to determine the performance level of Anadolu University in the provision of e-services and to understand the areas that require improvement and student expectations. Strategic goals and suggestions will be made to decision-makers, students, and researchers in line with the findings obtained in the research. Thus, it is planned to contribute to e-governance and user satisfaction in educational institutions and to reveal practical implications for optimizing online platforms to better serve student needs.

Keywords: e-service, Anadolu university, student satisfaction, e-governance, e-govqual, importance performance analysis

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Authors: Yusra Pintaningrum, Ilma Fahira Basyir, Sony Hilal Wicaksono, Vito A. Damay

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Background: Coronary artery calcium (CAC) scores play an important role in improving prognostic accuracy and can be selectively used to guide the allocation of statin therapy for atherosclerotic cardiovascular disease outcomes and potentially associated with the occurrence of MACE (Major Adverse Cardiovascular Event) and MI (Myocardial Infarction). Objective: This systematic review and meta-analysis aim to analyze the findings of a study about CAC Score and statin treatment effect on MI and MACE risk. Methods: Search for published scientific articles using the PRISMA (Preferred Reporting, Items for Systematic Reviews and Meta-Analysis) method conducted on PubMed, Cochrane Library, and Medline databases published in the last 20 years on “coronary artery calcium” AND “statin” AND “cardiovascular disease” Further systematic review and meta-analysis using RevMan version 5.4 were performed based on the included published scientific articles. Results: Based on 11 studies included with a total of 1055 participants, we performed a meta-analysis and found that individuals with CAC score > 0 increased risk ratio of MI 8.48 (RR = 9.48: 95% CI: 6.22 – 14.45) times and MACE 2.48 (RR = 3.48: 95% CI: 2.98 – 4.05) times higher than CAC score 0 individual. Statin compared against non-statin treatment showed a statistically insignificant overall effect on the risk of MI (P = 0.81) and MACE (P = 0.89) in an individual with elevated CAC score 1 – 100 (P = 0.65) and > 100 (P = 0.11). Conclusions: This study found that an elevated CAC scores individual has a higher risk of MI and MACE than a non-elevated CAC score individual. There is no significant effect of statin compared against non-statin treatment to reduce MI and MACE in elevated CAC score individuals of 1 – 100 or > 100.

Keywords: coronary artery calcium, statin, cardiovascular disease, myocardial infarction, MACE

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Authors: W. R. M. Shehani Shanika

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Selling goods and services using images, names and personalities of celebrities has become a common marketing strategy identified in modern physical and online markets. Two concepts called globalization and open economy have given numerous reasons to develop businesses to earn higher profits. Therefore, global market plus domestic markets in various countries have vigorously endorsing images of famous sport stars, film stars, singing stars and cartoon characters for the purpose of increasing demand for goods and services rendered by them. It has been evident that these trade strategies have become a threat to famous personalities in financially and personally. Right to the image is a basic human right which celebrities owned to avoid themselves from various commercial exploitations. In this respect, this paper aims to assess whether the law relating to character merchandising satisfactorily protects right to image of celebrities. However, celebrities can decide how much they receive for each representation to the general public. Simply they have exclusive right to decide monetary value for their image. But most commonly every country uses law relating to unfair competition to regulate matters arise thereof. Legal norms in unfair competition are not enough to protect image of celebrities. Therefore, celebrities must be able to avoid unauthorized use of their images for commercial purposes by fraudulent traders and getting unjustly enriched, as their images have economic value. They have the right for use their image for any commercial purpose and earn profits. Therefore it is high time to recognize right to image as a new dimension to be protected in the legal framework of character merchandising. Unfortunately, to the author’s best knowledge there are no any uniform, single international standard which recognizes right to the image of celebrities in the context of character merchandising. The paper identifies it as a controversial legal barrier faced by celebrities in the rapidly evolving marketplace. Finally, this library-based research concludes with proposals to ensure the right to image more broadly in the legal context of character merchandising.

Keywords: brand endorsement, celebrity, character merchandising, intellectual property rights, right to image, unfair competition

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Authors: Afaf Manzoor, Abdul Hameed

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Children with hearing impairment face several challenges in accessing primary and secondary education in general and higher education in particular in Pakistan. A large number of these children are excluded from formal education system through segregated special institutions. The enrollment rate of these children at school level is very low and it continues decreasing as they move on the ladder of education. Negligible number of students with hearing impairment gets any chance to be enrolled at tertiary or higher education institutes. The segregated system of education at primary and secondary level makes it even more difficult to adjust in an inclusive classroom at a higher level not only for students with hearing impairment but for their teachers and peers as well. A false belief of teachers and parents about low academic profile of students with hearing impairment is one of the major challenges to overcome for their participation at higher education. This case study was conducted to document an innovative step taken by the Department of Special Education Needs, University of Management & Technology, Lahore Pakistan. The prime objective of this study was to assess the satisfaction level of students with hearing impairment in BS 4 Years and MA Special Education programs at Lahore campus. Structured interviews were of 40 students with hearing impairment to assess the satisfaction on service delivery (admission process, classroom pedagogy, content, assessment/results, access to other services centers i.e. library, cafeteria, hostel, co-curricular activities) and campus life. Their peers without disabilities were also interviewed to assess their acceptance level. The findings of the study revealed positive results about their educational as well as social inclusion in the university. The students also shared their fears at the time of admission and how fear eventually faded out with the passage of time due to the proper academic support system. The findings of the study will be shared in detail with the audience during the presentation.

Keywords: students with hearing impairment, higher education, inclusive education, marginalization

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Authors: Ricardo Pinto Mario Covele, Patricio V. Langa, Patrick Swanzy

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The English language has been recognized as a universal medium of instruction in academia, especially in Higher Education Institutions (HEIs) hence exerting enormous influence within the context of research and publication. By extension, the English Language has been embraced by scholars from non-English speaking countries. The purpose of this review was to synthesize the discussions using four databases. Discussion in the English language in the career development of academics, particularly in non-English speaking universities, is largely less visible. This paper seeks to fill this gap and to improve the visibility of the English language in the career development of academics focusing on non-English language speaking universities by undertaking a systematic literature review. More specifically, the paper addresses the language policy, English language learning model as a second language, sociolinguistic field and career development, methods, as well as its main findings. This review analyzed 75 relevant resources sourced from Western Cape’s Library, Scopus, Google scholar, and web of science databases from November 2020 to July 2021 using the PQRS framework as an analytical lens. The paper’s findings demonstrate that, while higher education continues to be under-challenges of English language usage, literature targeting non-English speaking universities remains less discussed than it is often described. The findings also demonstrate the dominance of English language policy, both for knowledge production and dissemination of literature challenging emerging scholars from non-English speaking HEIs. Hence, the paper argues for the need to reconsider the context of non-English language speakers in the English language in the career development of academics’ research, both as empirical fields and as emerging knowledge producers. More importantly, the study reveals two bodies of literature: (1) the instrumentalist approach to English Language learning and (2) Intercultural approach to the English Language for career opportunities, classified as the appropriate to explain the English language learning process and how is it perceived towards scholars’ academic careers in HEIs.

Keywords: English language, public and private universities, language policy, career development, non-English speaking countries

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Authors: Sathyaseelan Subramaniam, Jacqueline Bober, Jennifer Chao, Shahriar Zehtabchi

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Background: Emergency physicians frequently evaluate skin and soft tissue infections in order to differentiate abscess from cellulitis. This helps determine which patients will benefit from incision and drainage. Our objective was to determine the operating characteristics of point-of-care ultrasound (POCUS) compared to clinical examination in identifying abscesses in emergency department (ED) patients with features of skin and soft tissue infections. Methods: We performed a comprehensive search in the following databases: Medline, Web of Science, EMBASE, CINAHL and Cochrane Library. Trials were included if they compared the operating characteristics of POCUS with clinical examination in identifying skin and soft tissue abscesses. Trials that included patients with oropharyngeal abscesses or that requiring abscess drainage in the operating room were excluded. The presence of an abscess was determined by pus drainage. No pus seen on incision or resolution of symptoms without pus drainage at follow up, determined the absence of an abscess. Quality of included trials was assessed using GRADE criteria. Operating characteristics of POCUS are reported as sensitivity, specificity, positive likelihood (LR+) and negative likelihood (LR-) ratios and the respective 95% confidence intervals (CI). Summary measures were calculated by generating a hierarchical summary receiver operating characteristic model (HSROC). Results: Out of 3203 references identified, 5 observational studies with 615 patients in aggregate were included (2 adults and 3 pediatrics). We rated the quality of 3 trials as low and 2 as very low. The operating characteristics of POCUS and clinical examination in identifying soft tissue abscesses are presented in the table. The HSROC for POCUS revealed a sensitivity of 96% (95% CI = 89-98%), specificity of 79% (95% CI = 71-86), LR+ of 4.6 (95% CI = 3.2-6.8), and LR- of 0.06 (95% CI = 0.02-0.2). Conclusion: Existing evidence indicates that POCUS is useful in identifying abscesses in ED patients with skin or soft tissue infections.

Keywords: abscess, point-of-care ultrasound, pocus, skin and soft tissue infection

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Authors: M. Ahmadi, Sh. Damanabi, F. Sadoughi

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National Health Information System plays an important role in ensuring timely and reliable access to Health information which is essential for strategic and operational decisions that improve health, quality and effectiveness of health care. In other words, by using the National Health information system you can improve the quality of health data, information and knowledge used to support decision making at all levels and areas of the health sector. Since full identification of the components of this system for better planning and management influential factors of performance seems necessary, therefore, in this study, different attitudes towards components of this system are explored comparatively. Methods: This is a descriptive and comparative kind of study. The society includes printed and electronic documents containing components of the national health information system in three parts: input, process, and output. In this context, search for information using library resources and internet search were conducted and data analysis was expressed using comparative tables and qualitative data. Results: The findings showed that there are three different perspectives presenting the components of national health information system, Lippeveld, Sauerborn, and Bodart Model in 2000, Health Metrics Network (HMN) model from World Health Organization in 2008 and Gattini’s 2009 model. All three models outlined above in the input (resources and structure) require components of management and leadership, planning and design programs, supply of staff, software and hardware facilities, and equipment. In addition, in the ‘process’ section from three models, we pointed up the actions ensuring the quality of health information system and in output section, except Lippeveld Model, two other models consider information products, usage and distribution of information as components of the national health information system. Conclusion: The results showed that all the three models have had a brief discussion about the components of health information in input section. However, Lippeveld model has overlooked the components of national health information in process and output sections. Therefore, it seems that the health measurement model of network has a comprehensive presentation for the components of health system in all three sections-input, process, and output.

Keywords: National Health Information System, components of the NHIS, Lippeveld Model

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Authors: Ruichong Zhang, Fadi Sawaged, Lotfi Gargab

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This paper introduces a wave-based approach for system identification of high-rise building structures with a pair of seismic recordings, which can be used to evaluate structural integrity and detect damage in post-earthquake structural condition assessment. The fundamental of the approach is based on wave features of generalized impulse and frequency response functions (GIRF and GFRF), i.e., wave responses at one structural location to an impulsive motion at another reference location in time and frequency domains respectively. With a pair of seismic recordings at the two locations, GFRF is obtainable as Fourier spectral ratio of the two recordings, and GIRF is then found with the inverse Fourier transformation of GFRF. With an appropriate continuous model for the structure, a closed-form solution of GFRF, and subsequent GIRF, can also be found in terms of wave transmission and reflection coefficients, which are related to structural physical properties above the impulse location. Matching the two sets of GFRF and/or GIRF from recordings and the model helps identify structural parameters such as wave velocity or shear modulus. For illustration, this study examines ten-story Millikan Library in Pasadena, California with recordings of Yorba Linda earthquake of September 3, 2002. The building is modelled as piecewise continuous layers, with which GFRF is derived as function of such building parameters as impedance, cross-sectional area, and damping. GIRF can then be found in closed form for some special cases and numerically in general. Not only does this study reveal the influential factors of building parameters in wave features of GIRF and GRFR, it also shows some system-identification results, which are consistent with other vibration- and wave-based results. Finally, this paper discusses the effectiveness of the proposed model in system identification.

Keywords: wave-based approach, seismic responses of buildings, wave propagation in structures, construction

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Authors: Stefanache Stefania, Ioana R. Podina

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Background: Embodied Conversational Agents (ECAs) are revolutionizing education and healthcare by offering cost-effective, adaptable, and portable solutions. Research on the Uncanny Valley effect (UVE) involves various embodied agents, including ECAs. Achieving the optimal level of anthropomorphism, no consensus on how to overcome the uncanniness problem. Objectives: This systematic review aims to identify the user characteristics, agent features, and context factors that influence the UVE. Additionally, this review provides recommendations for creating effective ECAs and conducting proper experimental studies. Methods: We conducted a systematic review following the PRISMA 2020 guidelines. We included quantitative, peer-reviewed studies that examined human-ECA interaction. We identified 17,122 relevant records from ACM Digital Library, IEE Explore, Scopus, ProQuest, and Web of Science. The quality of the predictors, mediators, and moderators adheres to the guidelines set by prior systematic reviews. Results: Based on the included studies, it can be concluded that females and younger people perceive the ECA as more attractive. However, inconsistent findings exist in the literature. ECAs characterized by extraversion, emotional stability, and agreeableness are considered more attractive. Facial expressions also play a role in the UVE, with some studies indicating that ECAs with more facial expressions are considered more attractive, although this effect is not consistent across all studies. Few studies have explored contextual factors, but they are nonetheless crucial. The interaction scenario and exposure time are important circumstances in human-ECA interaction. Conclusions: The findings highlight a growing interest in ECAs, which have seen significant developments in recent years. Given this evolving landscape, investigating the risk of the UVE can be a promising line of research.

Keywords: human-computer interaction, uncanny valley effect, embodied conversational agent, systematic review

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Authors: Van Truong Pham

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Background: Self-management was described as a potential strategy for blood pressure control in patients with hypertension. However, the effects of self-management interventions on blood pressure, self-efficacy, medication adherence, and body mass index (BMI) in older adults with hypertension have not been systematically evaluated. We evaluated the effects of self-management interventions on systolic blood pressure (SBP) and diastolic blood pressure (DBP), self-efficacy, medication adherence, and BMI in hypertensive older adults. Methods: We followed the recommended guidelines of preferred reporting items for systematic reviews and meta-analyses. Searches in electronic databases including CINAHL, Cochrane Library, Embase, Ovid-Medline, PubMed, Scopus, Web of Science, and other sources were performed to include all relevant studies up to April 2019. Studies selection, data extraction, and quality assessment were performed by two reviewers independently. We summarized intervention effects as Hedges' g values and 95% confidence intervals (CI) using a random-effects model. Data were analyzed using Comprehensive Meta-Analysis software 2.0. Results: Twelve randomized controlled trials met our inclusion criteria. The results revealed that self-management interventions significantly improved blood pressure control, self-efficacy, medication adherence, whereas the effect of self-management on BMI was not significant in older adult patients with hypertension. The following Hedges' g (effect size) values were obtained: SBP, -0.34 (95% CI, -0.51 to -0.17, p < 0.001); DBP, -0.18 (95% CI, -0.30 to -0.05, p < 0.001); self-efficacy, 0.93 (95%CI, 0.50 to 1.36, p < 0.001); medication adherence, 1.72 (95%CI, 0.44 to 3.00, p=0.008); and BMI, -0.57 (95%CI, -1.62 to 0.48, p = 0.286). Conclusions: Self-management interventions significantly improved blood pressure control, self-efficacy, and medication adherence. However, the effects of self-management on obesity control were not supported by the evidence. Healthcare providers should implement self-management interventions to strengthen patients' role in managing their health care.

Keywords: self-management, meta-analysis, blood pressure control, self-efficacy, medication adherence, body mass index

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Authors: Beatrice Fenu, Francesco Niosi, Giovanni Bracco, Giuliana Mattiazzo

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In recent years, Europe has seen a great development of renewable energy, in a perspective of reducing polluting emissions and transitioning to cleaner forms of energy, as established by the European Green New Deal. Wind energy has come to cover almost 15% of European electricity needs andis constantly growing. In particular, far-offshore wind turbines are attractive from the point of view of exploiting high-speed winds and high wind availability. Considering offshore wind turbine siting that combines the resources analysis, the bathymetry, environmental regulations, and maritime traffic and considering the waves influence in the stability of the platform, the hydrodynamic characteristics of the platform become fundamental for the evaluation of the performances of the turbine, especially for the pitch motion. Many platform's geometries have been studied and used in the last few years. Their concept is based upon different considerations as hydrostatic stability, material, cost and mooring system. A new method to reach a high-performances substructure for different kinds of wind turbines is proposed. The system that considers substructure, mooring, and wind turbine is implemented in Orcaflex, and the simulations are performed considering several sea states and wind speeds. An external dynamic library is implemented for the turbine control system. The study shows the comparison among different substructures and the new concepts developed. In order to validate the model, CFD simulations will be performed by mean of STAR CCM+, and a comparison between rigid and elastic body for what concerns blades and tower will be carried out. A global model will be built to predict the productivity of the floating turbine according to siting, resources, substructure, and mooring. The Levelized Cost of Electricity (LCOE) of the system is estimated, giving a complete overview about the advantages of floating offshore wind turbine plants. Different case studies will be presented.

Keywords: aero-hydrodynamic model, computational fluid dynamics, floating offshore wind, siting, verification, and validation

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Authors: Miriam Fahmy, Shalini Fernando

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Educational links between teaching hospitals and universities can provide visits with great impact for both sides. As a visitor, one is responsible for the content, respecting current practice while offering guidance from a completely different perspective. There is little documented guidance for establishing links with universities in developing countries and providing meaningful teaching and exchange programmes. An initial contact retrieved one response with regards to written curriculum. The otolaryngology department from a Swansea teaching hospital visited a university in the Gambia. A consultant and clinical fellow visited with medical students to deliver lectures, clinical skills and informal teaching such as bedside and small group teaching. Students who had participated in teaching provided by the visiting university were asked to give feedback. This information was collated and used to evaluate the impact, and to guide future visits, including thinking of establishing a curriculum tailored to the West Africa region. The students felt they gained the most from informal sessions such as bedside teaching and felt that more practical experience on real patients and pathology would be most beneficial to them. Given that internet is poor, they also suggested a video library for their reference. Many of them look forward to visiting Swansea and are interested in the differences in practice and technologies. The findings are limited to little previous literature and student feedback. Student feedback sparked further questions and careful contemplation. There is great scope for introducing a range of teaching resources but it is important to avoid assumptions and imposition of a western curriculum and education system, a larger sample is needed with input from lecturers and curriculum writers in leading universities. In conclusion, more literature and guidance needs to be established for future visitors contemplating an educational link.

Keywords: education, impact, West Africa, university links

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