Search results for: evidence based medicine
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 31468

Search results for: evidence based medicine

30958 Implementing Peer Mediated Interventions with Visual Supports for Social Skills Development in a School-Based Work Setting with Secondary Students with Autism

Authors: Karen Eastman

Abstract:

More youths and young adults with autism spectrum disorder (ASD) have been entering the workforce in recent years. Historically, students with ASD struggle after leaving high school and experience lower rates of employment, with social skills continuing to be the most problematic area of concern. Special education teachers may find it challenging to identify effective combinations of evidence-based practices (EBPs) and supports to best guide these students. One EBP, Peer Mediated Instruction and Intervention (PMII) has been well documented in the literature as being effective for younger students with autism but not researched as much with older students and adults, particularly in work settings. A need to combine PMII with other EBPs has been identified as a way to achieve a greater positive impact rather than any practice alone. A multiple baseline across skills design was used in this research project with two participants in different settings. PMII was combined with Visual Supports, with typical peers being trained in both practices. PMII is an evidence-based practice used to address social concerns by training peers without disabilities as to how they can provide feedback to and support, the student with ASD with social interactions in structured settings. The peers without disabilities were the instructors, while the adults facilitated the social situations and provided support to both the peers and students with ASD when needed. Because many individuals with ASD learn best with visual input, rather than using only the spoken word (verbal directions and feedback), Visual Supports were used in conjunction with PMII. Visual Supports can include written words, pictures, symbols, videos, or objects. In this project, the Visual Supports used were written social scripts, videos, Stop and Think signs, written reminder cards, a school map, and a pictorial task analysis of work tasks. Variables that may affect intervention outcomes in this project included attendance at school and school-based work settings for both the students with ASD and the peers without disabilities and behaviors and responses from others in the settings. Qualitative data was also collected from observations and surveys with peers about the process and their role. Data indicated that the students with ASD responded more positively to redirection and support from their peers than to teachers and staff and showed an increase in positive interactions with others. Those surveyed indicated a positive attitude toward and response to the use of peer interventions with visual supports.

Keywords: autism, social skills, vocational training, peer interventions

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30957 Study on Evaluating the Utilization of Social Media Tools (SMT) in Collaborative Learning Case Study: Faculty of Medicine, King Khalid University

Authors: Vasanthi Muniasamy, Intisar Magboul Ejalani, M.Anandhavalli, K. Gauthaman

Abstract:

Social Media (SM) are websites increasingly popular and built to allow people to express themselves and to interact socially with others. Most SMT are dominated by youth particularly college students. The proliferation of popular social media tools, which can accessed from any communication devices has become pervasive in the lives of today’s student life. Connecting traditional education to social media tools are a relatively new era and any collaborative tool could be used for learning activities. This study focuses (i) how the social media tools are useful for the learning activities of the students of faculty of medicine in King Khalid University (ii) whether the social media affects the collaborative learning with interaction among students, among course instructor, their engagement, perceived ease of use and perceived ease of usefulness (TAM) (iii) overall, the students satisfy with this collaborative learning through Social media.

Keywords: social media, Web 2.0, perceived ease of use, perceived usefulness, collaborative Learning

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30956 Relevance Of Cognitive Rehabilitation Amongst Children Having Chronic Illnesses – A Theoretical Analysis

Authors: Pulari C. Milu Maria Anto

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Background: Cognitive Rehabilitation/Retraining has been variously used in the research literature to represent non-pharmacological interventions that target the cognitive impairments with the goal of ameliorating cognitive function and functional behaviors to optimize the quality of life. Along with adult’s cognitive impairments, the need to address acquired cognitive impairments (due to any chronic illnesses like CHD - congenital heart diseases or ALL - Acute Lymphoblastic Leukemia) among child populations is inevitable. Also, it has to be emphasized as same we consider the cognitive impairments seen in the children having neurodevelopmental disorders. Methods: All published brain image studies (Hermann, B. et al,2002, Khalil, A. et al., 2004, Follin, C. et al, 2016, etc.) and studies emphasizing cognitive impairments in attention, memory, and/or executive function and behavioral aspects (Henkin, Y. et al,2007, Bellinger, D. C., & Newburger, J. W. (2010), Cheung, Y. T., et al,2016, that could be identified were reviewed. Based on a systematic review of the literature from (2000 -2021) different brain imaging studies, increased risk of neuropsychological and psychosocial impairments are briefly described. Clinical and research gap in the area is discussed. Results:30 papers, both Indian studies and foreign publications (Sage journals, Delhi psychiatry journal, Wiley Online Library, APA PsyNet, Springer, Elsevier, Developmental medicine, and child neurology), were identified. Conclusions: In India, a very limited number of brain imaging studies and neuropsychological studies have done by indicating the cognitive deficits of a child having or undergone chronic illness. None of the studies have emphasized the relevance nor the need of implementingCR among such children, even though its high time to address but still not established yet. The review of the current evidence is to bring out an insight among rehabilitation professionals in establishing a child specific CR and to publish new findings regarding the implementation of CR among such children. Also, this study will be an awareness on considering cognitive aspects of a child having acquired cognitive deficit (due to chronic illness), especially during their critical developmental period.

Keywords: cognitive rehabilitation, neuropsychological impairments, congenital heart diseases, acute lymphoblastic leukemia, epilepsy, and neuroplasticity

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30955 The Use of Ontology Framework for Automation Digital Forensics Investigation

Authors: Ahmad Luthfi

Abstract:

One of the main goals of a computer forensic analyst is to determine the cause and effect of the acquisition of a digital evidence in order to obtain relevant information on the case is being handled. In order to get fast and accurate results, this paper will discuss the approach known as ontology framework. This model uses a structured hierarchy of layers that create connectivity between the variant and searching investigation of activity that a computer forensic analysis activities can be carried out automatically. There are two main layers are used, namely analysis tools and operating system. By using the concept of ontology, the second layer is automatically designed to help investigator to perform the acquisition of digital evidence. The methodology of automation approach of this research is by utilizing forward chaining where the system will perform a search against investigative steps and atomically structured in accordance with the rules of the ontology.

Keywords: ontology, framework, automation, forensics

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30954 Health Care Students' Attitudes, Knowledge and Use of Complementary and Alternative Medicine: A Cross Sectional Study

Authors: Caterina Grandi, Lukas Lochner, Marco Padovan, Mirco Rizzi, Paola Sperinde, Fabio Vittadello, Luisa Cavada

Abstract:

Background: In recent years, the use of Complementary Alternative Medicine (CAM) has achieved worldwide popularity. With the increased public interest in CAMs, attention to it within Health Care Schools and Colleges has also improved. Studies generally assess the knowledge and attitudes regarding CAMs in medical and nursing students. The current study focused on the knowledge, attitudes and practice of CAM in healthcare students. Aim: To assess the knowledge and attitudes regarding complementary and alternative medicine (CAM) in healthcare students in South Tyrol, a region in Northern Italy. Methodology: This cross-sectional study was carried out among 361 students. Self-administered questionnaire was adapted and modified by the researchers from several questionnaires. The instrument consisted of three sections: 1) demographical characteristics (gender, place of residence and year of study); 2) general attitudes towards CAM, evaluated through 11 items using a Likert scale (agree, partly agree, partly disagree, disagree); 3) knowledge and use about any particular CAM practices (acupuncture, aromatherapy, creative therapies, diet/nutritional therapies, phytotherapy/herbal therapies, compresses, massage therapy, Ayurvedic therapy, Tibetan medicine, naturopathy, homeopathy, pet therapy, reflexology, therapeutic touch, chiropractic/osteopathy). Results: The sample consisted of 63 males and 297 females, 58% living in villages. 151 students (42%) were in the first year, 99 (27%) in the second and 106 (30%) in the third. Both men and women agreed with statements about the utility and benefits of CAMs. Women were significantly more likely than men to agree that the CAM practices should be included in the curriculum (p < 0.004), that the health professionals should be able to advice their patients about commonly used CAM methods (p < 0.002) and that the clinical care should integrate CAM practices (p < 0.04). Students in the second year showed the highest mean score for the statement 'CAM includes ideas and methods from which conventional medicine could benefit' (p = 0.049), highlighting a positive attitude, while students in the third year achieved the lowest mean score for the negative statement 'The results of CAM are in most cases due to a placebo effect'. Regarding this statement, participants living in villages disagreed significantly than students living in the city (p < 0.001). Females appeared to be significantly more familiar with homeopathy (p < 0.002), aromatherapy (p < 0.033), creative therapies (p < 0.001) and herbal therapies (p<0.002) than males. Moreover, women were likely to use CAM more frequently than men, particularly to solve psychological problems (p < 0.004). In addition, women perceived the benefit significantly more positive than men (p < 0.001). Students in the second year revealed to use the CAM mostly to improve the quality of life (p < 0.023), while students in the third year used CAMs particularly for chronic diseases (p < 0.001). Conclusions: Results from this study suggested that female students show more positive attitudes on CAM than male students. Moreover, the prevalence of CAM use and its perceived benefits differ between males and females, so that women are more willing to use CAM practices.

Keywords: attitude, CAM, complementary and alternative medicine, healthcare students, knowledge

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30953 Molecular Diversity of Forensically Relevant Insects from the Cadavers of Lahore

Authors: Sundus Mona, Atif Adnan, Babar Ali, Fareeha Arshad, Allah Rakha

Abstract:

Molecular diversity is the variation in the abundance of species. Forensic entomology is a neglected field in Pakistan. Insects collected from the crime scene should be handled by forensic entomologists who are currently virtually non-existent in Pakistan. Correct identification of insect specimen along with knowledge of their biodiversity can aid in solving many problems related to complicated forensic cases. Inadequate morphological identification and insufficient thermal biological studies limit the entomological utility in Forensic Medicine. Recently molecular identification of entomological evidence has gained attention globally. DNA barcoding is the latest and established method for species identification. Only proper identification can provide a precise estimation of postmortem intervals. Arthropods are known to be the first tourists scavenging on decomposing dead matter. The objective of the proposed study was to identify species by molecular techniques and analyze their phylogenetic importance with barcoded necrophagous insect species of early succession on human cadavers. Based upon this identification, the study outcomes will be the utilization of established DNA bar codes to identify carrion feeding insect species for concordant estimation of post mortem interval. A molecular identification method involving sequencing of a 658bp ‘barcode’ fragment of the mitochondrial cytochrome oxidase subunit 1 (CO1) gene from collected specimens of unknown dipteral species from cadavers of Lahore was evaluated. Nucleotide sequence divergences were calculated using MEGA 7 and Arlequin, and a neighbor-joining phylogenetic tree was generated. Three species were identified, Chrysomya megacephala, Chrysomya saffranea, and Chrysomya rufifacies with low genetic diversity. The fixation index was 0.83992 that suggests a need for further studies to identify and classify forensically relevant insects in Pakistan. There is an exigency demand for further research especially when immature forms of arthropods are recovered from the crime scene.

Keywords: molecular diversity, DNA barcoding, species identification, forensically relevant

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30952 Sports and Exercise Medicine: A Public Health Tool in Combating and Preventing the Side Effects of a Sedentary Lifestyle

Authors: Shireen Ibish

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Physical inactivity and unhealthy diets have contributed to a global burden of disease with increased relation to non-communicable diseases, increased risk of colon and breast cancer, high prevalence of depression, reduced quality of life and early death. The World Health Organisation’s facts on Obesity show a tripling in prevalence across the European Region since the 1980s. This has lead to a huge public health burden, being responsible for and 10-13% of deaths (fourth largest cause of global mortality) and 2-8% of health costs in the Region. In the UK alone, the present cost of physical inactivity has been estimated to be £8.2 billion. In 2002 a paper published in the International Journal of Epidemiology on ‘sedentary’ lifestyle, put into figures the increasingly worrying statistics across European countries. “Percentages of sedentary lifestyles across European countries ranged between 43.3% (Sweden) and 87.8% (Portugal)”. This was especially so amongst obese subjects, less- educated people, and smokers. While in the UK’s “50% of adult population in the UK is predicted to be obese by 2050.” Sports and Exercise Medicine, as a specialty, has a lot to offer in targeting this globally increasing epidemic. The worrying figures and the increasing knowledge of combating and preventing this issue have lead to increased awareness amongst the medical profession and more targeted interventions to reduce the burden of disease. “The public health element of the specialty is critical – this is not simply a specialty for the management of elite athletes’ medical conditions – it is central to the promotion of exercise as a means of disease prevention, to enhance well-being and in the management of disease.” WHO advised on creating National policies, encouraging and providing opportunities for greater physical activity, and improve the affordability, availability and accessibility of healthy foods. In the UK various different movements have been established to target this problem. The Motivate2Move, Move Eat Treat and guidelines advising specialties on targeting and encouraging exercise in the population (Sport and Exercise Medicine A Fresh Approach).

Keywords: sedentary lifestyle, obesity, public health burden, medicine

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30951 Does "R and D" Investment Drive Economic Growth? Evidence from Africa

Authors: Boopen Seetanah, R. V. Sannassee, Sheereen Fauzel, Robin Nunkoo

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The bulk of research on the impact of research and development (R&D) has been carried out in developed economies where the intensity of R&D expenditure has been relatively high and stable for many years. However, there is a paucity of similar studies in developing countries. In this paper, we provide empirical estimates of the impact of R&D investment on economic growth in a developing African economy (Mauritius) where R&D expenditure intensity has been low initially, but rising, albeit moderately in recent years. Using a dynamic time series analysis over the period 1980 to 2014 in a Vector Autoregressive framework, R & D is shown to have a positive and significant effect on the economic progress of the island, although the impact is considerably less when compared to both other ingredients of growth and also to reported elasticities fromdeveloped economies . Interestingly, there is evidence of bicausality between R & D and growth. furthermore, R & D positively impacts on both domestic and foreign investment, suggesting the possibilities of indirect effects.

Keywords: R & D, VECM, Africa, Mauritius

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30950 Forensic Entomology in Algeria

Authors: Meriem Taleb, Ghania Tail, Fatma Zohra Kara, Brahim Djedouani, T. Moussa

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Forensic entomology is the use of insects and their arthropod relatives as silent witnesses to aid legal investigations by interpreting information concerning a death. The main purpose of forensic entomology is to establish the postmortem interval or PMI Postmortem interval is a matter of crucial importance in the investigations of homicide and other untimely deaths when the body found is after three days. Forensic entomology has grown immensely as a discipline in the past thirty years. In Algeria, forensic entomology was introduced in 2010 by the National Institute for Criminalistics and Criminology of the National Gendarmerie (NICC). However, all the work that has been done so far in this growing field in Algeria has been unknown at both the national and international levels. In this context, the aim of this paper is to describe the state of forensic entomology in Algeria. The Laboratory of Entomology of the NICC is the only one of its kind in Algeria. It started its activities in 2010, consisting of two specialists. The main missions of the laboratory are estimation of the PMI by the analysis of entomological evidence, and determination if the body was moved. Currently, the laboratory is performing different tasks such as the expert work required by investigators to estimate the PMI using the insects. The estimation is performed by the accumulated degree days method (ADD) in most of the cases except for those where the cadaver is in dry decay. To assure the quality of the entomological evidence, crime scene personnel are trained by the laboratory of Entomology of the NICC. Recently, undergraduate and graduate students have been studying carrion ecology and insect activity in different geographic locations of Algeria using rabbits and wild boar cadavers as animal models. The Laboratory of Entomology of the NICC has also been involved in some of these research projects. Entomotoxicology experiments are also conducted with the collaboration of the Toxicology Department of the NICC. By dint of hard work that has been performed by the Laboratory of Entomology of the NICC, official bodies have been adopting more and more the use of entomological evidence in criminal investigations in Algeria, which is commendable. It is important, therefore, that steps are taken to fill in the gaps in the knowledge necessary for entomological evidence to have a useful future in criminal investigations in Algeria.

Keywords: forensic entomology, corpse, insects, postmortem interval, expertise, Algeria

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30949 Analysis of Kinetin Supramolecular Complex with Glytsirrizinic Acid and Based by Mass-Spectrometry Method

Authors: Bakhtishod Matmuratov, Sakhiba Madraximova, Rakhmat Esanov, Alimjan Matchanov

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Studies have been performed to obtain complexes of glycyrrhizic acid and kinetins in a 2:1 ratio. The complex of glycyrrhizic acid and kinetins in a 2:1 ratio was considered evidence of the formation of a molecular complex by determining the molecular masses using chromato-mass spectroscopy and analyzing the IR spectra.

Keywords: monoammonium salt of glycyrrhizic acid, glycyrrhizic acid, supramolecular complex, isomolar series, IR spectroscopy

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30948 What Determine Corporate Board Diligence: Evidence from Sultanate of Oman

Authors: Badar Khalid Hakim Alshabibi

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This study aims to examine the determinants of corporate board diligence in the listed firm in Sultanate of Oman, using four corporate board characteristics, the board size, board independence, board gender diversity, and nationality diversity. Design/methodology/approach: Using a sample comprised of all companies listed in the Muscat Securities Exchange over a ten-year period (2009–2019), the study applies Pooled OLS regression to examine the determinants of corporate board diligence. Findings: Drawing from the agency theory and institutional theory, the results reveal that the number of independent board members had statistical significance, suggesting that board independence can improve corporate board diligence, though board size and nationality diversity were found to have a negative association with corporate board diligence. There is no evidence, however, that board gender diversity improves corporate board diligence. Practical implications: The study provides insights for both the investors and regulatory authorities in developing economies. For the investors to be aware about the corporate board characteristics which enhance board monitoring, and for the regulatory authorities to consider revising the corporate governance codes which enhance the quality of governance practices. Originality/value: The study provides new evidence documenting the determinants of corporate board diligence in a developing country such as the Sultanate of Oman, which has a high potential for growth and attracting foreign investment, as stated in Oman vision 2040. In addition, this paper is the first to examine the association between corporate board diligence and corporate board diversity aspects.

Keywords: board diligence, board monitoring, board composition, board diversity, oman

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30947 The Effect of Silanization on Alumina for Improving the Compatibility with Poly(Methacrylic Acid) Matrix for Dental Restorative Materials

Authors: Andrei Tiberiu Cucuruz, Ecaterina Andronescu, Cristina Daniela Ghitulica, Andreia Cucuruz

Abstract:

In modern dentistry, the application of resin-based composites continues to increase and in the majority of countries has completely replaced mercury amalgams. Alumina (Al2O3) is a representative bioinert ceramic with a variety of applications in industry as well as in medicine. Alumina has the potential to improve electrical resistivity and thermal conductivity of polymers. The application of poly(methacrylic acid) (PMAA) in medicine was poorly investigated in the past but can lead to good results by the incorporation of alumina particles that can bring bioinertness to the composite. However, because of the differences related to chemical bonding of these materials, the interaction is very weak at the interface leading to no significant values in practical situations. The aim of this work was to modify the structure of alumina with silane coupling agents and to study the influence of silanization on the physicomechanical properties of the resulting composite materials. Two silanes were used in this study: 3-aminopropyl-trimethoxysilane (APTMS) and dichlorodimethylsilane (DCDMS). Both silanes proved to have a significant effect on the overall performance of composites by establishing bonds with the polymer matrix and the filler. All these improvements in dental adhesive systems made for bonding resin composites to tooth structure have enhanced the clinical application of polymeric restorative materials to the position that they are now considered the material of choice for esthetic restoration.

Keywords: alumina, compressive strength, dental materials, silane coupling agents, poly(methacrylic acid)

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30946 Moral Rights: Judicial Evidence Insufficiency in the Determination of the Truth and Reasoning in Brazilian Morally Charged Cases

Authors: Rainner Roweder

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Theme: The present paper aims to analyze the specificity of the judicial evidence linked to the subjects of dignity and personality rights, otherwise known as moral rights, in the determination of the truth and formation of the judicial reasoning in cases concerning these areas. This research is about the way courts in Brazilian domestic law search for truth and handles evidence in cases involving moral rights that are abundant and important in Brazil. The main object of the paper is to analyze the effectiveness of the evidence in the formation of judicial conviction in matters related to morally controverted rights, based on the Brazilian, and as a comparison, the Latin American legal systems. In short, the rights of dignity and personality are moral. However, the evidential legal system expects a rational demonstration of moral rights that generate judicial conviction or persuasion. Moral, in turn, tends to be difficult or impossible to demonstrate in court, generating the problem considered in this paper, that is, the study of the moral demonstration problem as proof in court. In this sense, the more linked to moral, the more difficult to be demonstrated in court that right is, expanding the field of judicial discretion, generating legal uncertainty. More specifically, the new personality rights, such as gender, and their possibility of alteration, further amplify the problem being essentially an intimate manner, which does not exist in the objective, rational evidential system, as normally occurs in other categories, such as contracts. Therefore, evidencing this legal category in court, with the level of security required by the law, is a herculean task. It becomes virtually impossible to use the same evidentiary system when judging the rights researched here; therefore, it generates the need for a new design of the evidential task regarding the rights of the personality, a central effort of the present paper. Methodology: Concerning the methodology, the Method used in the Investigation phase was Inductive, with the use of the comparative law method; in the data treatment phase, the Inductive Method was also used. Doctrine, Legislative, and jurisprudential comparison was the technique research used. Results: In addition to the peculiar characteristics of personality rights that are not found in other rights, part of them are essentially linked to morale and are not objectively verifiable by design, and it is necessary to use specific argumentative theories for their secure confirmation, such as interdisciplinary support. The traditional pragmatic theory of proof, for having an obvious objective character, when applied in the rights linked to the morale, aggravates decisionism and generates legal insecurity, being necessary its reconstruction for morally charged cases, with the possible use of the “predictive theory” ( and predictive facts) through algorithms in data collection and treatment.

Keywords: moral rights, proof, pragmatic proof theory, insufficiency, Brazil

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30945 Analysis of the Transcriptional Response of Rhazia stricta to Jasmonic Acid Induction

Authors: Nahid H. Hajrah, Jamal S. M. Sabir, Neil Hall

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The jasmonic pathway is ubiquitous in plants and is crucial to plant development. It Is involved in fertility, ripening, and sex determination as well as in response to environmental stresses such as herbivory, pathogen drought or temperature shock. Essentially the jasmonic pathway acts to shut down growth in order to induce defence pathways. These pathways include the production of secondary metabolites which have evolved to defend against herbivores and pathogens but are of increasing interest due to their roll in medicine and biotechnology. Here we describe the transcriptional response of Rhazia stricta (a poisonous shrub widely used in traditional medicine) to jasmonic acid, in order to better characterize the genes involved in secondary metabolite production and its response to stress. We observe coordinated upregulation of flavonoid biosynthesis pathway leading to flavonols, flavones and anthocyanins but no similar coordination of the monoterpene indole alkaloid pathway.

Keywords: medicinal plants, Rhazia stricta, jasmonic acid, transcriptional analysis

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30944 Chinese Undergraduates’ Trust in And Usage of Machine Translation: A Survey

Authors: Bi Zhao

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Neural network technology has greatly improved the output of machine translation in terms of both fluency and accuracy, which greatly increases its appeal for young users. The present exploratory study aims to find out how the Chinese undergraduates perceive and use machine translation in their daily life. A survey is conducted to collect data from 100 undergraduate students from multiple Chinese universities and with varied academic backgrounds, including arts, business, science, engineering, and medicine. The survey questions inquire about their use (including frequency, scenarios, purposes, and preferences) of and attitudes (including trust, quality assessment, justifications, and ethics) toward machine translation. Interviews and tasks of evaluating machine translation output are also employed in combination with the survey on a sample of selected respondents. The results indicate that Chinese undergraduate students use machine translation on a daily basis for a wide range of purposes in academic, communicative, and entertainment scenarios. Most of them have preferred machine translation tools, but the availability of machine translation tools within a certain scenario, such as the embedded machine translation tool on the webpage, is also the determining factor in their choice. The results also reveal that despite the reportedly limited trust in the accuracy of machine translation output, most students lack the ability to critically analyze and evaluate such output. Furthermore, the evidence is revealed of the inadequate awareness of ethical responsibility as machine translation users among Chinese undergraduate students.

Keywords: Chinese undergraduates, machine translation, trust, usage

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30943 How Can Personal Protective Equipment Be Best Used and Reused: A Human Factors based Look at Donning and Doffing Procedures

Authors: Devin Doos, Ashley Hughes, Trang Pham, Paul Barach, Rami Ahmed

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Over 115,000 Health Care Workers (HCWs) have died from COVID-19, and millions have been infected while caring for patients. HCWs have filed thousands of safety complaints surrounding safety concerns due to Personal Protective Equipment (PPE) shortages, which included concerns around inadequate and PPE reuse. Protocols for donning and doffing PPE remain ambiguous, lacking an evidence-base, and often result in wide deviations in practice. PPE donning and doffing protocol deviations commonly result in self-contamination but have not been thoroughly addressed. No evidence-driven protocols provide guidance on protecting HCW during periods of PPE reuse. Objective: The aim of this study was to examine safety-related threats and risks to Health Care Workers (HCWs) due to the reuse of PPE among Emergency Department personnel. Method: We conducted a prospective observational study to examine the risks of reusing PPE. First, ED personnel were asked to don and doff PPE in a simulation lab. Each participant was asked to don and doff PPE five times, according to the maximum reuse recommendation set by the Centers for Disease Control and Prevention (CDC). Each participant was videorecorded; video recordings were reviewed and coded independently by at least 2 of the 3trained coders for safety behaviors and riskiness of actions. A third coder was brought in when the agreement between the 2 coders could not be reached. Agreement between coders was high (81.9%), and all disagreements (100%) were resolved via consensus. A bowtie risk assessment chart was constructed analyzing the factors that contribute to increased risks HCW are faced with due to PPE use and reuse. Agreement amongst content experts in the field of Emergency Medicine, Human Factors, and Anesthesiology was used to select aspects of health care that both contribute and mitigate risks associated with PPE reuse. Findings: Twenty-eight clinician participants completed five rounds of donning/doffing PPE, yielding 140 PPE donning/doffing sequences. Two emerging threats were associated with behaviors in donning, doffing, and re-using PPE: (i) direct exposure to contaminant, and (ii) transmission/spread of contaminant. Protective behaviors included: hand hygiene, not touching the patient-facing surface of PPE, and ensuring a proper fit and closure of all PPE materials. 100% of participants (n= 28) deviated from the CDC recommended order, and most participants (92.85%, n=26) self-contaminated at least once during reuse. Other frequent errors included failure to tie all ties on the PPE (92.85%, n=26) and failure to wash hands after a contamination event occurred (39.28%, n=11). Conclusions: There is wide variation and regular errors in how HCW don and doffPPE while including in reusing PPE that led to self-contamination. Some errors were deemed “recoverable”, such as hand washing after touching a patient-facing surface to remove the contaminant. Other errors, such as using a contaminated mask and accidentally spreading to the neck and face, can lead to compound risks that are unique to repeated PPE use. A more comprehensive understanding of the contributing threats to HCW safety and complete approach to mitigating underlying risks, including visualizing with risk management toolsmay, aid future PPE designand workflow and space solutions.

Keywords: bowtie analysis, health care, PPE reuse, risk management

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30942 Exploring Subjective Simultaneous Mixed Emotion Experiences in Middle Childhood

Authors: Esther Burkitt

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Background: Evidence is mounting that mixed emotions can be experienced simultaneously in different ways across the lifespan. Four types of patterns of simultaneously mixed emotions (sequential, prevalent, highly parallel, and inverse types) have been identified in middle childhood and adolescence. Moreover, the recognition of these experiences tends to develop firstly when children consider peers rather than the self. This evidence from children and adolescents is based on examining the presence of experiences specified in adulthood. The present study, therefore, applied an exhaustive coding scheme to investigate whether children experience types of previously unidentified simultaneous mixed emotional experiences. Methodology: One hundred and twenty children (60 girls) aged 7 years 1 month - 9 years 2 months (X=8 years 1 month; SD = 10 months) were recruited from mainstream schools across the UK. Two age groups were formed (youngest, n = 61, 7 years 1 month- 8 years 1 months: oldest, n = 59, 8 years 2 months – 9 years 2 months) and allocated to one of two conditions hearing vignettes describing happy and sad mixed emotion events in age and gender-matched protagonist or themselves. Results: Loglinear analyses identified new types of flexuous, vertical, and other experiences along with established sequential, prevalent, highly parallel, and inverse types of experience. Older children recognised more complex experiences other than the self-condition. Conclusion: Several additional types of simultaneously mixed emotions are recognised in middle childhood. The theoretical relevance of simultaneous mixed emotion processing in childhood is considered, and the potential utility of the findings in emotion assessments is discussed.

Keywords: emotion, childhood, self, other

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30941 Bioactive Molecules Isolated for the First Time from Hyoscyamus albus L. and their Mechanisms Underlying the Anticancer Effects

Authors: Benhouda Afaf, Yahia Massinissa, Paolo Grieco

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Hyoscyamus albus L. is a small genus from Solanaceae family known by its use in old traditional medicine in the east of Algeria. Aim: This study aimed to characterize bioactive molecules from H. albus, evaluate their anticancer activity in several cancer cells and investigate their possible molecular mechanism. Materials and Methods: Different compounds (Peak h of fraction F), (Peak 3 of Fraction F), (Peak 1 of fraction C) were isolated from H.albus L by using high-performance chromatography (HPLC), mass spectrometry (MS) and proton NMR (NMR H1). All isolated compounds were subjected to cytotoxicity and antiproliferative assays against a panel of the four cell lines: DU-145, U-2 OS, U-87 MG and LN-229 cell lines and were determined using MTT assay, Annexin V and propodium iodide were used to evaluate apoptosis. Results: The phytochemical study of H. albus Fractions led to the isolation of quercetin-3-O-β-dglucopyranosyl-( 1 → 6)-β-d-glucopyranosid, N-trans-feruloyltyramine, Hydrocaffeoyl-N8- caffeoylspermidine.The biological results indicated that all cell lines were consistently sensitive to P1 FC in a dose-dependent manner. This difference in cytotoxic sensitivity was more pronounced in osteosarcoma cell line, U-2 OS, when compared to prostate cancer and U-87 MG. Cell viability data also demonstrated that only U-87 MG cells were responsive to treatment with Ph FF. compounds P1 FC and Ph FF have induced necrosis and apoptosis in a large part of LN-229 cells. Conclusion: The overall results of the present study provided evidence that isolated compounds are potential therapeutic entities against cancer.

Keywords: hyoscyamus albus, cancer cells, coumpounds, HPLC

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30940 Re-Stating the Origin of Tetrapod Using Measures of Phylogenetic Support for Phylogenomic Data

Authors: Yunfeng Shan, Xiaoliang Wang, Youjun Zhou

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Whole-genome data from two lungfish species, along with other species, present a valuable opportunity to re-investigate the longstanding debate regarding the evolutionary relationships among tetrapods, lungfishes, and coelacanths. However, the use of bootstrap support has become outdated for large-scale phylogenomic data. Without robust phylogenetic support, the phylogenetic trees become meaningless. Therefore, it is necessary to re-evaluate the phylogenies of tetrapods, lungfishes, and coelacanths using novel measures of phylogenetic support specifically designed for phylogenomic data, as the previous phylogenies were based on 100% bootstrap support. Our findings consistently provide strong evidence favoring lungfish as the closest living relative of tetrapods. This conclusion is based on high internode certainty, relative gene support, and high gene concordance factor. The evidence stems from five previous datasets derived from lungfish transcriptomes. These results yield fresh insights into the three hypotheses regarding the phylogenies of tetrapods, lungfishes, and coelacanths. Importantly, these hypotheses are not mere conjectures but are substantiated by a significant number of genes. Analyzing real biological data further demonstrates that the inclusion of additional taxa leads to more diverse tree topologies. Consequently, gene trees and species trees may not be identical even when whole-genome sequencing data is utilized. However, it is worth noting that many gene trees can accurately reflect the species tree if an appropriate number of taxa, typically ranging from six to ten, are sampled. Therefore, it is crucial to carefully select the number of taxa and an appropriate outgroup, such as slow-evolving species, while excluding fast-evolving taxa as outgroups to mitigate the adverse effects of long-branch attraction and achieve an accurate reconstruction of the species tree. This is particularly important as more whole-genome sequencing data becomes available.

Keywords: novel measures of phylogenetic support for phylogenomic data, gene concordance factor confidence, relative gene support, internode certainty, origin of tetrapods

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30939 Cell-Based and Exosome Treatments for Hair Restoration

Authors: Armin Khaghani Boroujeni, Leila Dehghani, Parham Talebi Boroujeni, Sahar Rostamian, Ali Asilian

Abstract:

Background: Hair loss is a common complaint observed in both genders. Androgenetic alopecia is known pattern for hair loss. To assess new regenerative strategies (PRP, A-SC-BT, conditioned media, exosome-based treatments) compared to conventional therapies for hair loss or hair regeneration, an updated review was undertaken. To address this issue, we carried out this systematic review to comprehensively evaluate the efficacy of cell-based therapies on hair loss. Methods: The available online databases, including ISI Web of Science, Scopus, and PubMed, were searched systematically up to February 2022. The quality assessment of included studies was done using the Cochrane Collaboration's tool. Results: As a result, a total of 90 studies involving 2345 participants were included in the present study. The enrolled studies were conducted between 2010 and 2022. The subjects’ mean age ranged from 19 to 55.11 years old. Approaches using platelet rich plasma (PRP) provide a beneficial impact on hair regrowth. However, other cell-based therapies, including stem cell transplant, stem cell-derived conditioned medium, and stem cell-derived exosomes, revealed conflicting evidence. Conclusion: However, cell-based therapies for hair loss are still in their infancy, and more robust clinical studies are needed to better evaluate their mechanisms of action, efficacy, safety, benefits, and limitations. In this review, we provide the resources to the latest clinical studies and a more detailed description of the latest clinical studies concerning cell-based therapies in hair loss.

Keywords: cell-based therapy, exosome, hair restoration, systematic review

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30938 Motivational Interviewing as a Framework for Coaching Physicians through ACGME Milestones

Authors: Michael Olson

Abstract:

The Accreditation Council for Graduate Medical Education (ACGME) in the U.S. has established core competencies and milestones for family physicians in residency training programs. These competencies are intended to guide preceptors as they work with physician trainees toward independent practice. This conceptual paper describes a framework for coaching trainees toward these milestones using motivational interviewing as an evidence-based approach. The main objective of applying the motivational interviewing framework to the residency training setting is to facilitate clinical behavior change that meets higher level competencies/rubric. This is a work in progress and there is no manuscript/paper prepared to date. A conceptual paper/framework will be completed by the conference deadline. This is based on a separate but related development of work we have completed and published elsewhere.

Keywords: coaching, motivational interviewing, physicians, competencies

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30937 3D Printing of Dual Tablets: Modified Multiple Release Profiles for Personalized Medicine

Authors: Veronika Lesáková, Silvia Slezáková, František Štěpánek

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Additive manufacturing technologies producing drug dosage forms aimed at personalized medicine applications are promising strategies with several advantages over the conventional production methods. One of the emerging technologies is 3D printing which reduces manufacturing steps and thus allows a significant drop in expenses. A decrease in material consumption is also a highly impactful benefit as the tested drugs are frequently expensive substances. In addition, 3D printed dosage forms enable increased patient compliance and prevent misdosing as the dosage forms are carefully designed according to the patient’s needs. The incorporation of multiple drugs into a single dosage form further increases the degree of personalization. Our research focuses on the development of 3D printed tablets incorporating multiple drugs (candesartan, losartan) and thermoplastic polymers (e.g., KlucelTM HPC EF). The filaments, an essential feed material for 3D printing,wereproduced via hot-melt extrusion. Subsequently, the extruded filaments of various formulations were 3D printed into tablets using an FDM 3D printer. Then, we have assessed the influence of the internal structure of 3D printed tablets and formulation on dissolution behaviour by obtaining the dissolution profiles of drugs present in the 3D printed tablets. In conclusion, we have developed tablets containing multiple drugs providing modified release profiles. The 3D printing experiments demonstrate the high tunability of 3D printing as each tablet compartment is constructed with a different formulation. Overall, the results suggest that the 3D printing technology is a promising manufacturing approach to dual tablet preparation for personalized medicine.

Keywords: 3D printing, drug delivery, hot-melt extrusion, dissolution kinetics

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30936 The Role of Named Entity Recognition for Information Extraction

Authors: Girma Yohannis Bade, Olga Kolesnikova, Grigori Sidorov

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Named entity recognition (NER) is a building block for information extraction. Though the information extraction process has been automated using a variety of techniques to find and extract a piece of relevant information from unstructured documents, the discovery of targeted knowledge still poses a number of research difficulties because of the variability and lack of structure in Web data. NER, a subtask of information extraction (IE), came to exist to smooth such difficulty. It deals with finding the proper names (named entities), such as the name of the person, country, location, organization, dates, and event in a document, and categorizing them as predetermined labels, which is an initial step in IE tasks. This survey paper presents the roles and importance of NER to IE from the perspective of different algorithms and application area domains. Thus, this paper well summarizes how researchers implemented NER in particular application areas like finance, medicine, defense, business, food science, archeology, and so on. It also outlines the three types of sequence labeling algorithms for NER such as feature-based, neural network-based, and rule-based. Finally, the state-of-the-art and evaluation metrics of NER were presented.

Keywords: the role of NER, named entity recognition, information extraction, sequence labeling algorithms, named entity application area

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30935 Maternal-Fetal Bonding for African American Mothers

Authors: Tracey Estriplet-Adams

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This paper focuses on the influence of maternal-fetal bonding by examining attachment theory, psycho-social-cultural influences/adaptations, and maternal well-being. A systematic review methodology was used to synthesize research results to summarize current evidence that can contribute to evidence-based practices. It explores the relationship between attachment styles, prenatal attachment, and perceptions of maternal-infant bonding/attachment six weeks postpartum. It also examines the protective factors of maternal-fetal attachment development. The research explores Bowlby's attachment theory and its relevance to maternal-fetal bonding with a Black Feminist Theory lens. Additionally, it discusses the impact of perceived stress, social support, and ecological models on maternal-fetal attachment. The relationship between maternal well-being, maternal-fetal attachment, and early postpartum bonding is reviewed. Moreover, the paper specifically addresses black mothers and maternal-fetal bonding, exploring the intersectionality of race, ethnicity, class, geographic location, cultural identities, and immigration status. It considers the role of familial and partner support, as well as the relationship between maternal attachment style and maternal-fetal bonding, within the framework of attachment theory and black feminist theory. Therefore, it is imperative to center Black women's voices in research, policy, and healthcare practices. Black women are experts in their own experiences and advocate for their autonomy in decision-making regarding maternal-fetal health. By amplifying their voices, we can ensure that interventions are grounded in their lived experiences.

Keywords: maternal-fetal bonding, infant well-being, maternal-infant attachment, black mothers

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30934 Exercise and Geriatric Depression: a Scoping Review of the Research Evidence

Authors: Samira Mehrabi

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Geriatric depression is a common late-life mental health disorder that increases morbidity and mortality. It has been shown that exercise is effective in alleviating symptoms of geriatric depression. However, inconsistencies across studies and lack of optimal dose-response of exercise for improving geriatric depression have made it challenging to draw solid conclusions on the effectiveness of exercise in late-life depression. Purpose: To further investigate the moderators of the effectiveness of exercise on geriatric depression across the current body of evidence. Methods: Based on the Arksey and O’Malley framework, an extensive search strategy was performed by exploring PubMed, Scopus, Sport Discus, PsycInfo, ERIC, and IBSS without limitations in the time frame. Eight systematic reviews with empirical results that evaluated the effect of exercise on depression among people aged ≥ 60 years were identified and their individual studies were screened for inclusion. One additional study was found through the hand searching of reference lists. After full-text screening and applying inclusion and exclusion criteria, 21 studies were retained for inclusion. Results: The review revealed high variability in characteristics of the exercise interventions and outcome measures. Sample characteristics, nature of comparators, main outcome assessment, and baseline severity of depression also varied notably. Mind-body and aerobic exercises were found to significantly reduce geriatric depression. However, results on the relationship between resistance training and improvements in geriatric depression were inconsistent, and results of the intensity-related antidepressant effects of exercise interventions were mixed. Extensive use of self-reported questionnaires for the main outcome assessment and lack of evidence on the relationship between depression severity and observed effects were of the other important highlights of the review. Conclusion: Several literature gaps were found regarding the potential effect modifiers of exercise and geriatric depression. While acknowledging the complexity of establishing recommendations on the exercise variables and geriatric depression, future studies are required to understand the interplay and threshold effect of exercise for treating geriatric depression.

Keywords: exercise, geriatric depression, healthy aging, older adults, physical activity intervention, scoping review

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30933 Using Differentiated Instruction Applying Cognitive Approaches and Strategies for Teaching Diverse Learners

Authors: Jolanta Jonak, Sylvia Tolczyk

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Educational systems are tasked with preparing students for future success in academic or work environments. Schools strive to achieve this goal, but often it is challenging as conventional teaching approaches are often ineffective in increasingly diverse educational systems. In today’s ever-increasing global society, educational systems become increasingly diverse in terms of cultural and linguistic differences, learning preferences and styles, ability and disability. Through increased understanding of disabilities and improved identification processes, students having some form of disabilities tend to be identified earlier than in the past, meaning that more students with identified disabilities are being supported in our classrooms. Also, a large majority of students with disabilities are educated in general education environments. Due to cognitive makeup and life experiences, students have varying learning styles and preferences impacting how they receive and express what they are learning. Many students come from bi or multilingual households and with varying proficiencies in the English language, further impacting their learning. All these factors need to be seriously considered when developing learning opportunities for student's. Educators try to adjust their teaching practices as they discover that conventional methods are often ineffective in reaching each student’s potential. Many teachers do not have the necessary educational background or training to know how to teach students whose learning needs are more unique and may vary from the norm. This is further complicated by the fact that many classrooms lack consistent access to interventionists/coaches that are adequately trained in evidence-based approaches to meet the needs of all students, regardless of what their academic needs may be. One evidence-based way for providing successful education for all students is by incorporating cognitive approaches and strategies that tap into affective, recognition, and strategic networks in the student's brain. This can be done through Differentiated Instruction (DI). Differentiated Instruction is increasingly recognized model that is established on the basic principles of Universal Design for Learning. This form of support ensures that regardless of the students’ learning preferences and cognitive learning profiles, they have opportunities to learn through approaches that are suitable to their needs. This approach improves the educational outcomes of students with special needs and it benefits other students as it accommodates learning styles as well as the scope of unique learning needs that are evident in the typical classroom setting. Differentiated Instruction also is recognized as an evidence-based best practice in education and is highly effective when it is implemented within the tiered system of the Response to Intervention (RTI) model. Recognition of DI becomes more common; however, there is still limited understanding of the effective implementation and use of strategies that can create unique learning environments for each student within the same setting. Through employing knowledge of a variety of instructional strategies, general and special education teachers can facilitate optimal learning for all students, with and without a disability. A desired byproduct of DI is that it can eliminate inaccurate perceptions about the students’ learning abilities, unnecessary referrals for special education evaluations, and inaccurate decisions about the presence of a disability.

Keywords: differentiated instruction, universal design for learning, special education, diversity

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30932 Ontologies for Social Media Digital Evidence

Authors: Edlira Kalemi, Sule Yildirim-Yayilgan

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Online Social Networks (OSNs) are nowadays being used widely and intensively for crime investigation and prevention activities. As they provide a lot of information they are used by the law enforcement and intelligence. An extensive review on existing solutions and models for collecting intelligence from this source of information and making use of it for solving crimes has been presented in this article. The main focus is on smart solutions and models where ontologies have been used as the main approach for representing criminal domain knowledge. A framework for a prototype ontology named SC-Ont will be described. This defines terms of the criminal domain ontology and the relations between them. The terms and the relations are extracted during both this review and the discussions carried out with domain experts. The development of SC-Ont is still ongoing work, where in this paper, we report mainly on the motivation for using smart ontology models and the possible benefits of using them for solving crimes.

Keywords: criminal digital evidence, social media, ontologies, reasoning

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30931 Exploring the Issue of Occult Hypoperfusion in the Pre-Hospital Setting

Authors: A. Fordham, A. Hudson

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Background: Studies have suggested 16-25% of normotensive trauma patients with no clinical signs of shock have abnormal lactate and BD readings evidencing shock; a phenomenon known as occult hypoperfusion (OH). In light of the scarce quantity of evidence currently documenting OH, this study aimed to identify the prevalence of OH in the pre-hospital setting and explore ways to improve its identification and management. Methods: A quantitative retrospective data analysis was carried out on 75 sets of patient records for trauma patients treated by Kent Surrey Sussex Air Ambulance Trust between November 2013 and October 2014. The KSS HEMS notes and subsequent ED notes were collected. Trends between patients’ SBP on the scene, whether or not they received PRBCs on the scene as well as lactate and BD readings in the ED were assessed. Patients’ KSS HEMS notes written by the HEMS crew were also reviewed and recorded. Results: -Suspected OH was identified in 7% of the patients who did not receive PRBCs in the pre-hospital phase. -SBP heavily influences the physicians’ decision of whether or not to transfuse PRBCs in the pre-hospital phase. Preliminary conclusions: OH is an under-studied and underestimated phenomenon. We suggest a prospective trial is carried out to evaluate whether detecting trauma patients’ tissue perfusion status in the pre-hospital phase using portable devices capable of measuring serum BD and/or lactate could aid more accurate detection and management of all haemorrhaging trauma patients, including patients with OH.

Keywords: occult hypoperfusion, PRBC transfusion, point of care testing, pre-hospital emergency medicine, trauma

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30930 The Role of Organizational Culture in Facilitating Employee Job Satisfaction in Emerald Group

Authors: Mohamed Haffar, Muhammad Abdul Aziz, Ahmad Ghoneim

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The importance of having a good organizational culture that supports employee job satisfaction has fascinated both the business and academic world because of a tantalizing promise: culture can be fundamental to the enhancement of financial performance. This promise has led to growing interest for both researchers and practitioners in attempting to understand the influence of organizational culture on employees’ satisfaction and organizational performance. Even though the relationship between organizational culture and employee job satisfaction have gained attention in the literature, the majority of studies have been conducted within manufacturing organizations and tend to oversee the impact of culture on employee job satisfaction in a service-based environment. Thus, the main driving force of this study was to explore the role of organizational culture types in facilitating employee job satisfaction at Emerald Publishing Group. Interviews qualitative data analysis indicated that Emerald’s culture dominated by adhocracy and clan culture values. In addition, the findings provided evidence, which demonstrated that group and adhocracy organizational culture types play key roles in facilitating employee job satisfaction in a service-based environment.

Keywords: employee satisfaction, organizational culture, performance, service based environment

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30929 An Exploratory Research on Childhood Sexual Victimization and Its Psychological Impacts

Authors: Urwah Ali

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The aim of this study is to carry out a meta-analysis in order to establish an overall international figure and to summarize the evidence relating to the possible relationship between child sexual abuse and subsequent mental and physical health outcomes. A systematic review was conducted using the HEC Digital Library, Pub Med, PsycINFO and SAHIL databases published after 2010 containing empirical data pertaining to CSA. Out of 124 articles assessed for eligibility, 32 studies provided evidence of a relationship between sexual child maltreatment and various health outcomes for use in subsequent meta-analyses. Statistical significance associations were observed between childhood sexual victimization and psychological problems in their adulthood [odds ratio (OR) = 1.5; 95%Cl 3.07–4.43]. For most studies included for meta-analysis, the odds ratio falls above 1.00, indicating that patients having history of childhood sexual victimization were more likely to develop psychological disorders.

Keywords: abuse, sexual abuse, childhood sexual abuse, mental health

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