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Authors: Saidasanov Saidazal Shokhmurodovich, Topolnickiy Orest Zinovyevich, Afaunova Olga Arturovna

Abstract:

Relevance: Bilateral congenital cleft is one of the most complex forms of all clefts, which makes it difficult to choose a surgical method of treatment. During primary operations to close the hard and soft palate, there is a shortage of soft tissues and their lack during standard uranoplasty, and these factors aggravate the period of rehabilitation of patients. Materials and methods: The results of surgical treatment of children with bilateral cleft, who underwent uranoplasty using a flap from the tongue, were analyzed. The study used methods: clinical and statistical, which allowed us to solve the tasks, based on the principles of evidence-based medicine. Results and discussion: in our study, 15 patients were studied, who underwent surgical treatment in the following volume: uranoplasty using a flap from the tongue in two stages. Of these, 9 boys and 6 girls aged 2.5 to 6 years. The first stage was surgical treatment in the volume: veloplasty. The second stage was a surgical intervention in volume: uranoplasty using a flap from the tongue. In all patients, the width of the cleft ranged from 1.6-2.8 cm. All patients in this group were orthodontically prepared. Using this method, the surgeon can achieve the following results: maximum narrowing of the palatopharyngeal ring, long soft palate, complete closure of the hard palate, alveolar process, and the mucous membrane of the nasal cavity is also sutured, which creates good conditions for the next stage of osteoplastic surgery. Based on the result obtained, patients have positive results of working with a speech therapist. In all patients, the dynamics were positive without complications. Conclusions: Based on our observation, tongue flap uranoplasty is one of the effective techniques for patients with wide clefts of the hard and soft palate. The use of a flap from the tongue makes it possible to reduce the number of repeated reoperations and improve the quality of social adaptation of this group of patients, which is one of the important stages of rehabilitation. Upon completion of the stages of rehabilitation, all patients had the maximum improvement in functional, anatomical and social indicators.

Keywords: congenital cleft lips and palate, bilateral cleft, child surgery, maxillofacial surgery

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Authors: Sonia A. Stoica, Lexi Frankel, Amalia Ardeljan, Selena Rashid, Ali Yasback, Omar Rashid

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Introduction Enterococcus is a vast genus of lactic acid bacteria, gram-positivecocci species. They are common commensal organisms in the intestines of humans: E. faecalis (90–95%) and E. faecium (5–10%). Rare groups of infections can occur with other species, including E. casseliflavus, E. gallinarum, and E. raffinosus. The most common infections caused by Enterococcus include urinary tract infections, biliary tract infections, subacute endocarditis, diverticulitis, meningitis, septicemia, and spontaneous bacterial peritonitis. The treatment for sensitive strains of these bacteria includes ampicillin, penicillin, cephalosporins, or vancomycin, while the treatment for resistant strains includes daptomycin, linezolid, tygecycline, or streptogramine. Enterococcus faecalis CECT7121 is an encouraging nominee for being considered as a probiotic strain. E. faecalis CECT7121 enhances and skews the profile of cytokines to the Th1 phenotype in situations such as vaccination, anti-tumoral immunity, and allergic reactions. It also enhances the secretion of high levels of IL-12, IL-6, TNF alpha, and IL-10. Cytokines have been previously associated with the development of cancer. The intention of this study was to therefore evaluate the correlation between Enterococcus infections and incidence of bone carcinoma. Methods A retrospective cohort study (2010-2019) was conducted through a Health Insurance Portability and Accountability Act (HIPAA) compliant national database and conducted using International Classification of Disease (ICD) 9th and 10th codes for bone carcinoma diagnosis in a previously Enterococcus infected population. Patients were matched for age range and Charlson Comorbidity Index (CCI). Access to the database was granted by Holy Cross Health for academic research. Chi-squared test was used to assess statistical significance. Results A total number of 17,056 patients was obtained in Enterococcus infected group as well as in the control population (matched by Age range and CCI score). Subsequent bone carcinoma development was seen at a rate of 1.07% (184) in the Enterococcal infectious group and 3.42% (584) in the control group, respectively. The difference was statistically significant by p= 2.2x10-¹⁶, Odds Ratio = 0.355 (95% CI 0.311 - 0.404) Treatment for enterococcus infection was analyzed and controlled for in both enterococcus infected and noninfected populations. 78 out of 6,624 (1.17%) patients with a prior enterococcus infection and treated with antibiotics were compared to 202 out of 6,624 (3.04%) patients with no history of enterococcus infection (control) and received antibiotic treatment. Both populations subsequently developed bone carcinoma. Results remained statistically significant (p<2.2x10-), Odds Ratio=0.456 (95% CI 0.396-0.525). Conclusion This study shows a statistically significant correlation between Enterococcus infection and a decreased incidence of bone carcinoma. The immunologic response of the organism to Enterococcus infection may exert a protecting mechanism from developing bone carcinoma. Further exploration is needed to identify the potential mechanism of Enterococcus in reducing bone carcinoma incidence.

Keywords: anti-tumoral immunity, bone carcinoma, enterococcus, immunologic response

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Authors: Marina Karaseva

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The beginning of our century became a new digital epoch in the educational situation. Last decade the newest stage of this process had been initialized by the touch-screen mobile devices with program applications for them. The touch possibilities for learning fundamentals of music are of especially importance for music majors. The phenomenon of touching, firstly, makes it realistic to play on the screen as on music instrument, secondly, helps students to learn music theory while listening in its sound elements by music ear. Nowadays we can detect several levels of such mobile applications: from the basic ones devoting to the elementary music training such as intervals and chords recognition, to the more advanced applications which deal with music perception of non-major and minor modes, ethnic timbres, and complicated rhythms. The main purpose of the proposed paper is to disclose the main tendencies in this process and to demonstrate the most innovative features of music theory applications on the base of iOS and Android systems as the most common used. Methodological recommendations how to use these digital material musicologically will be done for the professional music education of different levels. These recommendations are based on more than ten year ‘iTheory’ teaching experience of the author. In this paper, we try to logically classify all types of ‘iTheory’mobile applications into several groups, according to their methodological goals. General concepts given below will be demonstrated in concrete examples. The most numerous group of programs is formed with simulators for studying notes with audio-visual links. There are link-pair types as follows: sound — musical notation which may be used as flashcards for studying words and letters, sound — key, sound — string (basically, guitar’s). The second large group of programs is programs-tests containing a game component. As a rule, their basis is made with exercises on ear identification and reconstruction by voice: sounds and intervals on their sounding — harmonical and melodical, music modes, rhythmic patterns, chords, selected instrumental timbres. Some programs are aimed at an establishment of acoustical communications between concepts of the musical theory and their musical embodiments. There are also programs focused on progress of operative musical memory (with repeating of sounding phrases and their transposing in a new pitch), as well as on perfect pitch training In addition a number of programs improvisation skills have been developed. An absolute pitch-system of solmisation is a common base for mobile programs. However, it is possible to find also the programs focused on the relative pitch system of solfegе. In App Store and Google Play Market online store there are also many free programs-simulators of musical instruments — piano, guitars, celesta, violin, organ. These programs may be effective for individual and group exercises in ear training or composition classes. Great variety and good sound quality of these programs give now a unique opportunity to musicians to master their music abilities in a shorter time. That is why such teaching material may be a way to effective study of music theory.

Keywords: ear training, innovation in music education, music theory, mobile devices

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Authors: K. C. Bloom, Cynde McInnis

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The Covid-19 pandemic has caused immense changes in the way that we live, work and travel. The impact of these changes is readily apparent in tourism to Massachusetts and the region of New England. Whereas, in general, Massachusetts and New England are a hotspot for travelers from around the world, this form of travel has largely been shut down due to the pandemic. One such area where the impact has been felt is in marine-based wildlife tourism. Massachusetts is home to not only whales but also seals and great white sharks. Prior to the pandemic, whale watching had long been a popular activity while seal and shark tourism has been a developing one. Given that seeing a great white shark was rare in New England for many years, shark tourism has not played a role in the economies of the region until recently. While whales have steadily been found within the marine environments of Massachusetts and whale watching has been a popular attraction since the mid-1970s, the lack of great white sharks in New England was, in part, a response to a change in their environment in that a favorite food source, the gray seals, were culled by regional fishermen as the fishermen believed that seals were taking their catch. This retaliatory behavior ended when the Marine Mammal Protection Act of 1972 (MMPA) was passed. The MMPA prohibited the killing of seals and since then the seal population has increased to traditional numbers (Tech Times, 2014). Given the increase in the seal population in New England, and especially Cape Cod, Massachusetts, there has been a similar increase in the numbers of great white sharks. In fact, over the time between 2004 and 2014, the number of sightings increased from an average of two per year to more than 20 (NY Post, 7/21/14). This has increased even more over the last six years. As a result, residents and businesses in Massachusetts have begun to embrace the great whites as a potential tourism draw. Local business owners are considering opening up cage diving and shark viewing businesses while there has also been an increase in shark-related merchandise throughout the Cape Cod region. Combined with a large whale watching industry, marine-based wildlife tourism is big business to Massachusetts. With the Covid-19 pandemic shuttering international travel, this study aims to look at the impacts of the pandemic on this industry. Through interviews with marine-based wildlife tourism businesses as well as survey data collection from visitors, this study looks at the holistic impacts of the Covid-19 pandemic on an important part of the marine tourism industry in the state.

Keywords: marine tourism, ecotourism, Covid, wildlife

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Authors: Babak Salekmahdy

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Microfinance is often seen as a means of repairing credit markets and unleashing the potential contribution of impoverished people who rely on self-employment. Since the 1990s, the microfinance industry has expanded rapidly, opening the path for additional kinds of social entrepreneurship and social investment. However, current data indicate relatively few average consumer effects, opposing pushback against microfinance. This research reconsiders microfinance statements, stressing the variety of data on impacts and the essential (but limited) role of reimbursements. The report finishes by explaining a shift in thinking: from microfinance as a strictly defined enterprise finance to microfinance as a more widely defined home finance. Microfinance, under this perspective, provides advantages by providing liquidity for various requirements rather than just by increasing income.

Keywords: microfinance, small business, economic development, credit markets

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Authors: Fatemeh Nikpay, Rodina Binti Ahmad, Babak Darvish Rouhani

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Enterprise Architecture (EA) is employed by enterprises for providing integrated Information Systems (ISs) in order to support alignment of their business and Information Technology (IT). Evaluation of EA implementation can support enterprise to reach intended goals. There are some problems in current evaluation methods of EA implementation that lead to ineffectiveness implementation of EA. This paper represents current issues on evaluation of EA implementation. In this regard, we set the framework in order to represent evaluation’s issues based on their functionality and structure. The results of this research not only increase the knowledge of evaluation, but also could be useful for both academics and practitioners in order to realize the current situation of evaluations.

Keywords: current issues on EA implementation evaluation, evaluation, enterprise architecture, evaluation of enterprise architecture implementation

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Authors: Sujesh F. Sujan, Steve W. Jones, Arto Kiviniemi

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The use of Building Information Modelling (BIM) in the Architectural-Engineering-Construction (AEC) industry is a form of systemic innovation. Unlike incremental innovation, (such as the technological development of CAD from hand based drawings to 2D electronically printed drawings) any form of systemic innovation in Project-Based Inter-Organisational Networks requires complete collaboration and results in numerous benefits if adopted and utilised properly. Proper use of BIM involves people collaborating with the use of interoperable BIM compliant tools. The AEC industry globally has been known for its adversarial and fragmented nature where firms take advantage of one another to increase their own profitability. Due to the industry’s nature, getting people to collaborate by unifying their goals is critical to successful BIM adoption. However, this form of innovation is often being forced artificially in the old ways of working which do not suit collaboration. This may be one of the reasons for its low global use even though the technology was developed more than 20 years ago. Therefore, there is a need to develop a metric/method to support and allow industry players to gain confidence in their investment into BIM software and workflow methods. This paper departs from defining systemic risk as a risk that affects all the project participants at a given stage of a project and defines categories of systemic risks. The need to generalise is to allow method applicability to any industry where the category will be the same, but the example of the risk will depend on the industry the study is done in. The method proposed seeks to use individual perception of an example of systemic risk as a key parameter. The significance of this study lies in relating the variance of individual perception of systemic risk to how much the team is collaborating. The method bases its notions on the claim that a more unified range of individual perceptions would mean a higher probability that the team is collaborating better. Since contracts and procurement devise how a project team operates, the method could also break the methodological barrier of highly subjective findings that case studies inflict, which has limited the possibility of generalising between global industries. Since human nature applies in all industries, the authors’ intuition is that perception can be a valuable parameter to study collaboration which is essential especially in projects that utilise systemic innovation such as BIM.

Keywords: building information modelling, perception of risk, systemic innovation, team collaboration

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Authors: Soodabeh Shahid Sales, Azam Rastgar Moghadam, Mehrane Mehramiz, Malihe Entezari, Kazem Anvari, Mohammad Sadegh Khorrami, Saeideh Ahmadi Simab, Ali Moradi, Seyed Mahdi Hassanian, Majid Ghayour-Mobarhan, Gordon A. Ferns, Amir Avan

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Background Esophageal cancer has been reported as the eighth most common cancer universal and the seventh cause of cancer-related death in men .recent studies have revealed that cytochrome P450, family 1, subfamily B, polypeptide 1, which plays a role in metabolizing xenobiotics, is associated with different cancers. Therefore in the present study, we investigated the impact of CYP1B1-rs1056836 on esophagus squamous cell carcinoma (ESCC) patients. Method: 317 subjects, with and without ESCC were recruited. DNA was extracted and genotyped via Real-time PCR-Based Taq Man. Kaplan Meier curves were utilized to assess overall and progression-free survival. To evaluate the relationship between patients clinicopathological data, genotypic frequencies, disease prognosis, and patients survival, Pearson chi-square and t-test were used. Logistic regression was utilized to assess the association between the risk of ESCC and genotypes. Results: the genotypic frequency for GG, GC, and CC are respectively 58.6% , 29.8%, 11.5% in the healthy group and 51.8%, 36.14% and 12% in ESCC group. With respect to the recessive genetic inheritance model, an association between the GG genotype and stage of ESCC were found. Also, statistically significant results were not found for this variation and risk of ESCC. Patients with GG genotype had a decreased risk of nodal metastasis in comparison with patients with CC/CG genotype, although this link was not statistically significant. Conclusion: Our findings illustrated the correlation of CYP1B1-rs1056836 as a potential biomarker for ESCC patients, supporting further studies in larger populations in different ethnic groups. Moreover, further investigations are warranted to evaluate the association of emerging marker with dietary intake and lifestyle.

Keywords: Cytochrome P450, esophagus squamous cell carcinoma, dietary intake, lifestyle

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Authors: B. González-Yebra, B. Flores-Nieto, P. Aguilar-Salinas, M. Preciado Puga, A. L. González Yebra

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The monitoring of populations occupationally exposed to organic solvents has been an important issue for several shoe factories for years since the International Agency for Research on Cancer (IARC) has advised on the potential carcinogenic risk of chemicals related to occupations. In order to detect if exposition to organic solvents used in some Mexican shoe factories contributes to oral carcinogenesis, we performed monitoring in three factories. Occupational exposure was determined by using monitors 3M. Organic solvents were assessed by gas chromatography. Then, we recruited 30 shoe workers (30.2 ± 8.4 years) and 10 unexposed subjects (43.3 ± 11.2 years) for the micronuclei (MN) test and immunodetection of some cancer biomarkers (ki-67, p16, caspase-3) in scraped oral epithelial cells. Monitored solvents detected were acetone, benzene, hexane, methyl ethyl ketone, and toluene in acceptable levels according to Official Mexican Norm. We found by MN test higher incidence of nuclear abnormalities (karyorrhexis, pycnosis, karyolysis, condensed chromatin, and macronuclei) in the exposed group than the non-exposed group. On the other hand, we found, a negative expression for Ki-67 and p16 in exfoliated epithelial cells from exposed and non-exposed to organic solvents subjects. Only caspase-3 shown positive patter of expression in 9/30 (30%) exposed subjects, and we detected high karyolysis incidence in caspase-3 subjects (p = 0.021). The absence of expression of proliferation markers p16 and ki-67 and presence of apoptosis marker caspase-3 are indicating the absence of malignancy in oral epithelial cells and low risk for oral cancer. It is a fact that the MN test is a very effective method to detect nuclear abnormalities in exfoliated buccal cells from subjects that have been exposed to organic solvents in the shoe industry. However, in order to improve this tool and predict cancer risk is it is mandatory to implement complementary tests as other biomarkers that can help to detect malignancy in individuals occupationally exposed.

Keywords: biomarkers, oral cancer, organic solvents, shoe industries

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Authors: Kate Allman, Heather Maranges, Elise Dykhuis

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Moral Growth Mindset (MGM) is the belief that one has the capacity to become a more moral person, as opposed to a fixed conception of one’s moral ability and capacity (Han et al., 2018). Building from Dweck’s work in incremental implicit theories of intelligence (2008), Moral Growth Mindset (Han et al., 2020) extends growth mindsets into the moral dimension. The concept of MGM has the potential to help researchers understand how both mindsets and interventions can impact character development, and it has even been shown to have connections to voluntary service engagement (Han et al., 2018). Understanding the contexts in which MGM might be cultivated could help to promote the further cultivation of character, in addition to prosocial behaviors like service engagement, which may, in turn, promote larger scale engagement in social justice-oriented thoughts, feelings, and behaviors. In particular, college may be a place to intentionally cultivate a growth mindset toward moral capacities, given the unique developmental and maturational components of the college experience, including contextual opportunity (Lapsley & Narvaez, 2006) and independence requiring the constant consideration, revision, and internalization of personal values (Lapsley & Woodbury, 2016). In a semester-long, quasi-experimental study, we examined the impact of a pedagogical approach designed to cultivate college student character development on participants’ MGM. With an intervention (n=69) and a control group (n=97; Pre-course: 27% Men; 66% Women; 68% White; 18% Asian; 2% Black; <1% Hispanic/Latino), we investigated whether college courses that intentionally incorporate character education pedagogy (Lamb, Brant, Brooks, 2021) affect a variety of psychosocial variables associated with moral thoughts, feelings, identity, and behavior (e.g. moral growth mindset, honesty, compassion, etc.). The intervention group consisted of 69 undergraduate students (Pre-course: 40% Men; 52% Women; 68% White; 10.5% Black; 7.4% Asian; 4.2% Hispanic/Latino) that voluntarily enrolled in five undergraduate courses that encouraged students to engage with key concepts and methods of character development through the application of research-based strategies and personal reflection on goals and experiences. Moral Growth Mindset was measured using the four-item Moral Growth Mindset scale (Han et al., 2020), with items such as You can improve your basic morals and character considerably on a six-point Likert scale from 1 (strongly disagree) to 6 (strongly agree). Higher scores of MGM indicate a stronger belief that one can become a more moral person with personal effort. Reliability at Time 1 was Cronbach’s ɑ= .833, and at Time 2 Cronbach’s ɑ= .772. An Analysis of Covariance (ANCOVA) was conducted to explore whether post-course MGM scores were different between the intervention and control when controlling for pre-course MGM scores. The ANCOVA indicated significant differences in MGM between groups post-course, F(1,163) = 8.073, p = .005, R² = .11, where descriptive statistics indicate that intervention scores were higher than the control group at post-course. Results indicate that intentional character development pedagogy can be leveraged to support the development of Moral Growth Mindset and related capacities in undergraduate settings.

Keywords: moral personality, character education, incremental theories of personality, growth mindset

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Authors: Henry Lau, Dilupa Nakandala, Li Zhao

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All along the length of the supply chain, fresh food firms face the challenge of managing both product quality, due to the perishable nature of the products, and product cost. This paper develops a method to assist logistics managers upstream in the fresh food supply chain in making cost optimized decisions regarding transportation, with the objective of minimizing the total cost while maintaining the quality of food products above acceptable levels. Considering the case of multiple fresh food products collected from multiple farms being transported to a warehouse or a retailer, this study develops a total cost model that includes various costs incurred during transportation. The practical application of the model is illustrated by using several computational intelligence approaches including Genetic Algorithms (GA), Fuzzy Genetic Algorithms (FGA) as well as an improved Simulated Annealing (SA) procedure applied with a repair mechanism for efficiency benchmarking. We demonstrate the practical viability of these approaches by using a simulation study based on pertinent data and evaluate the simulation outcomes. The application of the proposed total cost model was demonstrated using three approaches of GA, FGA and SA with a repair mechanism. All three approaches are adoptable; however, based on the performance evaluation, it was evident that the FGA is more likely to produce a better performance than the other two approaches of GA and SA. This study provides a pragmatic approach for supporting logistics and supply chain practitioners in fresh food industry in making important decisions on the arrangements and procedures related to the transportation of multiple fresh food products to a warehouse from multiple farms in a cost-effective way without compromising product quality. This study extends the literature on cold supply chain management by investigating cost and quality optimization in a multi-product scenario from farms to a retailer and, minimizing cost by managing the quality above expected quality levels at delivery. The scalability of the proposed generic function enables the application to alternative situations in practice such as different storage environments and transportation conditions.

Keywords: cost optimization, food supply chain, fuzzy sets, genetic algorithms, product quality, transportation

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Authors: Derek O Reilly, Piotr Milczarski, Shane Dowdall, Artur Hłobaż, Krzysztof Podlaski, Hiram Bollaert

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Learning through creation of contextual games is a very promising way/tool for interdisciplinary and international group projects. During 2013 and 2014 we took part and organized two intensive students projects in different conditions. The projects enrolled 68 students and 12 mentors from 5 countries. In the paper we want to share our experience how to strengthen the chances to succeed in short (12-15 days long) student projects. In our case almost all teams prepared working prototype and the results were highly appreciated by external experts.

Keywords: contextual games, mobile games, GGULIVRR, walkabout, Erasmus intensive programme

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Authors: Jameson Mirimu, Edward Mawejje, Ibra Twinomujuni

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Introduction: Adolescent girls and young women (AGYW) are a vulnerable category whose risk of acquiring HIV is 20 times compared to the general population accounting for 25% of the new infections. Despite proven scientific evidence of preventing HIV acquisition, Oral Pre-Exposure Prophylaxis (PreP) is less used as one of the biomedical interventions among the AGYW. By 2020, only 31000-32000 of the targeted 90,000 persons in Uganda enrolled on Oral PreP LPHS-EC project employed a combination of Expanded Peer Outreach Approach (EPOA) and Effective client follow-up to increase PreP initiation (PrEP_NEW) and continuation for more than three months (PrEP_CT). Method: Quantitatively, data from National Key population Combination tracker retrospectively analyzed by M&E, focused group discussion with AGYWs and Health care workers to identify barriers. Barriers found; hesitancy of AGYW, misconceptions about Oral PrEP, inadequate knowledge and skills in handling adolescent and Data quality issues. To address the mentioned barriers, youth friendly corners initiated in study sites, identified PrEP Champions among the AGYW, oral PrEP dialogues, group Antenatal counselling, CQI Projects initiated, weekly perfomance meetings to track performance. Results: Routine program data review PrEP_NEW and PrEP_CT increased from 5% (4/80) and 4% (2/54), respectively, in July 2022 to 90% (72/80) and 79% (43/54) respectively for PrEP_NEW and PrEP_CT at the end of March 2023. Lessons Learnt: Demystifying misconception about oral Prep through provision of adequate information by involving health care workers through skills enhancement, CQI projects are critical intervention. Conclusion: With improved safe spaces, skills enhancement of health workers, stakeholders’ engagement through Oral Prep dialogues is critical in improving PreP uptake and continuity among the AGYWS.

Keywords: prep, uptake, continuation, AGYW

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Authors: Sohail Bawani, Kausar S. Khan, Rozina Karmaliani, Shehnaz Mir

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Action research (AR) is one of the types of health systems research (HSR), and participatory action research (PAR) is known for being effective in health systems strengthening (HSS). The current literature on PAR for HSS cites numerous examples and case studies that led to improve health services; build child health information system; increase knowledge and awareness of people about health problems, and identify pathways for institutional and policy change by engaging people in research. But examples of marginalized communities being agents of change in health governance are not common in health systems research (HSR). This approach to PAR is at the heart of Paolo Freire’s Social Transformation Theory and Critical Consciousness building, which was used to design a community-based PAR study in the Northern/mountainous areas of Pakistan. The purpose of the study was to understand the place and role of marginalized communities in strengthening existing health governance structure (health facility and village health committees and health boards) by taking marginalized communities as partners. Community meetings were carried out to identify who is living at the social, political, cultural and economic margins in 40 different villages. Participatory reflection and analysis (PRA) tools were used during the meeting to facilitate identification. Focus group discussions were conducted with marginalized groups using PRA tools and family ethnographies with marginalized families identified through group discussions. Findings of the study revealed that for the marginalized health systems constitute more than just delivery of health services, but it also embraces social determinants that surround systems and its governance. The paper argues that from Frerian perspective people’s participation should not only be limited to knowledge generation. People must be seen active users of the knowledge that they generate for achieving better health outcomes that they want to achieve in the time to come. PAR provides a pathway to the marginalized in playing a role in health governance. The study dissemination planned shall engage the marginalized in a dialogue with service providers so that together a role for the marginalized can be outlined.

Keywords: participatory action research, health systems, marginalized, health services

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Authors: Raif Parlakkaya, Huseyin Cetin, Halil Akmese, Mesut Murat Adabali

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As the economies of other countries in the Mediterranean Basin, the tourism sector in our country has a high denominator in economics. Tourism businesses, which are building blocks of tourism, sector faces with a variety of problems during their activities. These problems faced make business efficiency and competition conditions of the businesses difficult. Most of the problems faced by the tourism businesses and the information of consumers about consumers’ rights were used in this study, which is conducted to determine the problems of tourism businesses in the Central Anatolia Region. It is aimed to contribute the awareness of staff and executives working at tourism sector and to attract attention of businesses active concurrently with tourism sector and legislators.

Keywords: financial problems, the problems of tourism businesses, tourism businesses, tourism sector in Turkey

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Authors: Robert Cazar, Nathaly Maza

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Energy drinks and sports drinks are quite popular among young adults and teenagers worldwide. Some concerns regarding their health effects – particularly those of the energy drinks - have been raised based on scientific findings. Differentiating between these two types of drinks by means of their chemical properties seems to be an instructive task. Chemometrics provides the most appropriate strategy to do so. In this study, a discrimination analysis of the energy and sports drinks has been carried out applying chemometric methods. A set of eleven samples of available commercial brands of drinks – seven energy drinks and four sports drinks – were collected. Each sample was characterized by eight chemical variables (carbohydrates, energy, sugar, sodium, pH, degrees Brix, density, and citric acid). The data set was standardized and examined by exploratory chemometric techniques such as clustering and principal component analysis. As a preliminary step, a variable selection was carried out by inspecting the variable correlation matrix. It was detected that some variables are redundant, so they can be safely removed, leaving only five variables that are sufficient for this analysis. They are sugar, sodium, pH, density, and citric acid. Then, a hierarchical clustering `employing the average – linkage criterion and using the Euclidian distance metrics was performed. It perfectly separates the two types of drinks since the resultant dendogram, cut at the 25% similarity level, assorts the samples in two well defined groups, one of them containing the energy drinks and the other one the sports drinks. Further assurance of the complete discrimination is provided by the principal component analysis. The projection of the data set on the first two principal components – which retain the 71% of the data information – permits to visualize the distribution of the samples in the two groups identified in the clustering stage. Since the first principal component is the discriminating one, the inspection of its loadings consents to characterize such groups. The energy drinks group possesses medium to high values of density, citric acid, and sugar. The sports drinks group, on the other hand, exhibits low values of those variables. In conclusion, the application of chemometric methods on a data set that features some chemical properties of a number of energy and sports drinks provides an accurate, dependable way to discriminate between these two types of beverages.

Keywords: chemometrics, clustering, energy drinks, principal component analysis, sports drinks

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Authors: Moldir Makenova

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Alongside the implementation of trilingual education in schools, the Ministry of Education and Science of the Republic of Kazakhstan innovated the school curriculum in 2013 to include a Content and Language Integrated Learning (CLIL) approach. In this regard, some transition issues have arisen, such as unprepared teachers, a need for more awareness of the CLIL approach, and teaching resources. Some teachers view it as a challenge due to its combination of both content and language. This often creates anxiety among teachers who are knowledgeable about their subject areas in Kazakh or Russian but are deficient in delivering the subject’s content in English. Thus, with this new teaching approach, teachers encounter to choose the role of language and answer how language works in the CLIL classroom. This study aimed to explore how teachers experience the changing role of language in the curriculum and to find out what challenges teachers face related to CLIL implementation and how their language proficiency influences their teaching practices. A qualitative comparative case study was conducted in an X Lyceum and a mainstream school piloting CLIL. Data collection procedures were conducted via semi-structured interviews, classroom observations, and document analysis. Eight content teachers were chosen from these two schools as the target group of this study. Subject teachers, rather than language teachers, were chosen as the target group to grasp how the language-related issues in the new curriculum are interpreted by educators who do not necessarily identify themselves as language experts at the outset. The findings showed that mainstream teachers prioritize content over language because, as content teachers, the knowledge of content is more essential for them rather than the language. In contrast, most X Lyceum teachers balance language and content and additionally showed their preferences to support the ‘English language only' policy among 10-11 graders. Moreover, due to the low-level English proficiency, mainstream teachers did highlight the necessity of CLIL training and further collaboration with language teachers. This study will be beneficial for teachers and policy-makers to enable them to solve the issues mentioned above related to the implementation of CLIL. Larger-scale research conducted in the future would further inform its successful deployment country-wide.

Keywords: role of language, trilingual education, updated curriculum, teacher practices

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Authors: Gokulan Vethanayakam, Daniel Aston

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Introduction: The ReSPECT process supports healthcare professionals when making patient-centered decisions in the event of an emergency. It has been widely adopted by the NHS in England and allows patients to express thoughts and wishes about treatments and outcomes that they consider acceptable. It includes (but is not limited to) cardiopulmonary resuscitation decisions. ReSPECT conversations should ideally occur prior to ICU admission and should be documented in the eight sections of the nationally-standardised ReSPECT form. This audit evaluated the use of ReSPECT on a busy cardiothoracic ICU in an NHS Trust where established policies advocating its use exist. Methods: This audit was a retrospective review of ReSPECT forms for a sample of high-risk patients admitted to ICU at the Royal Papworth Hospital between January 2021 and March 2022. Patients all received one of the following interventions: Veno-Venous Extra-Corporeal Membrane Oxygenation (VV-ECMO) for severe respiratory failure (retrieved via the national ECMO service); cardiac or pulmonary transplantation-related surgical procedures (including organ transplants and Ventricular Assist Device (VAD) implantation); or elective non-transplant cardiac surgery. The quality of documentation on ReSPECT forms was evaluated using national standards and a graded ranking tool devised by the authors which was used to assess narrative aspects of the forms. Quality was ranked as A (excellent) to D (poor). Results: Of 230 patients (74 VV-ECMO, 104 transplant, 52 elective non-transplant surgery), 43 (18.7%) had a ReSPECT form and only one (0.43%) patient had a ReSPECT form completed prior to ICU admission. Of the 43 forms completed, 38 (88.4%) were completed due to the commencement of End of Life (EoL) care. No non-transplant surgical patients included in the audit had a ReSPECT form. There was documentation of balance of care (section 4a), CPR status (section 4c), capacity assessment (section 5), and patient involvement in completing the form (section 6a) on all 43 forms. Of the 34 patients assessed as lacking capacity to make decisions, only 22 (64.7%) had reasons documented. Other sections were variably completed; 29 (67.4%) forms had relevant background information included to a good standard (section 2a). Clinical guidance for the patient (section 4b) was given in 25 (58.1%), of which 11 stated the rationale that underpinned it. Seven forms (16.3%) contained information in an inappropriate section. In a comparison of ReSPECT forms completed ahead of an EoL trigger with those completed when EoL care began, there was a higher number of entries in section 3 (considering patient’s values/fears) that were assessed at grades A-B in the former group (p = 0.014), suggesting higher quality. Similarly, forms from the transplant group contained higher quality information in section 3 than those from the VV-ECMO group (p = 0.0005). Conclusions: Utilisation of the ReSPECT process in high-risk patients is yet to be well-adopted in this trust. Teams who meet patients before hospital admission for transplant or high-risk surgery should be encouraged to engage with the ReSPECT process at this point in the patient's journey. VV-ECMO retrieval teams should consider ReSPECT conversations with patients’ relatives at the time of retrieval.

Keywords: audit, critical care, end of life, ICU, ReSPECT, resuscitation

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Authors: Kunal Garg, Louise Theusen Hermansan, Kanoktip Puttaraska, Oliver Hendricks, Heidi Pirttinen, Leona Gilbert

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The Germ Theory (one infectious determinant is equal to one disease) has unarguably evolved our capability to diagnose and treat infectious diseases over the years. Nevertheless, the advent of technology, climate change, and volatile human behavior has brought about drastic changes in our environment, leading us to question the relevance of the Germ Theory in our day, i.e. will vector-borne disease (VBD) sufferers produce multiple immune responses when tested for multiple microbes? Vector diseased patients producing multiple immune responses to different microbes would evidently suggest human polymicrobial infections (HPI). Ongoing diagnostic tools are exceedingly unequipped with the current research findings that would aid in diagnosing patients for polymicrobial infections. This shortcoming has caused misdiagnosis at very high rates, consequently diminishing the patient’s quality of life due to inadequate treatment. Equipped with the state-of-art scientific knowledge, PolyScan intends to address the pitfalls in current VBD diagnostics. PolyScan is a multiplex and multifunctional enzyme linked Immunosorbent assay (ELISA) platform that can test for numerous VBD microbes and allow simultaneous screening for multiple types of antibodies. To validate PolyScan, Lyme Borreliosis (LB) and spondyloarthritis (SpA) patient groups (n = 54 each) were tested for Borrelia burgdorferi, Borrelia burgdorferi Round Body (RB), Borrelia afzelii, Borrelia garinii, and Ehrlichia chaffeensis against IgM and IgG antibodies. LB serum samples were obtained from Germany and SpA serum samples were obtained from Denmark under relevant ethical approvals. The SpA group represented chronic LB stage because reactive arthritis (SpA subtype) in the form of Lyme arthritis links to LB. It was hypothesized that patients from both the groups will produce multiple immune responses that as a consequence would evidently suggest HPI. It was also hypothesized that the multiple immune response proportion in SpA patient group would be significantly larger when compared to the LB patient group across both antibodies. It was observed that 26% LB patients and 57% SpA patients produced multiple immune responses in contrast to 33% LB patients and 30% SpA patients that produced solitary immune responses when tested against IgM. Similarly, 52% LB patients and an astounding 73% SpA patients produced multiple immune responses in contrast to 30% LB patients and 8% SpA patients that produced solitary immune responses when tested against IgG. Interestingly, IgM immune dysfunction in both the patient groups was also recorded. Atypically, 6% of the unresponsive 18% LB with IgG antibody was recorded producing multiple immune responses with the IgM antibody. Similarly, 12% of the unresponsive 19% SpA with IgG antibody was recorded producing multiple immune responses with the IgM antibody. Thus, results not only supported hypothesis but also suggested that IgM may atypically prevail longer than IgG. The PolyScan concept will aid clinicians to detect patients for early, persistent, late, polymicrobial, & immune dysfunction conditions linked to different VBD. PolyScan provides a paradigm shift for the VBD diagnostic industry to follow that will drastically shorten patient’s time to receive adequate treatment.

Keywords: diagnostics, immune dysfunction, polymicrobial, TICK-TAG

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Authors: Mohamed Salaheldien Mohamed Alayat, Ahmed Mohamed Elsoudany, Roaa Abdulghani Sroge, Bayan Muteb Aldhahwani

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Background: Neck pain is a common illness that could affect individual’s daily activities. Class IV laser with longer wavelength can stimulate tissues and penetrate more than the classic low-level laser therapy. Objectives: The aim of the study was to investigate the efficacy of class IV diode laser in the treatment of patients with chronic neck pain (CNP). Methods: Fifty-two patients participated and completed the study. Their mean age (SD) was 50.7 (6.2). Patients were randomized into two groups and treated with laser plus exercise (laser + EX) group and placebo laser plus exercise (PL+EX) group. Treatment was performed by Class IV laser in two phases; scanning and trigger point phases. Scanning to the posterior neck and shoulder girdle region with 4 J/cm2 with a total energy of 300 J applied to 75 cm2 in 4 minutes and 16 seconds. Eight trigger points on the posterior neck area were treated by 4 J/cm2 and the time of application was in 30 seconds. Both groups received exercise two times per week for 4 weeks. Exercises included range of motion, isometric, stretching, isotonic resisted exercises to the cervical extensors, lateral bending and rotators muscles with postural correction exercises. The measured variables were pain level using visual analogue scale (VAS), and neck functional activity using neck disability index (NDI) score. Measurements were taken at baseline and after 4 weeks of treatment. The level of statistical significance was set as p < 0.05. Results: There were significant decreases in post-treatment VAS and NDI in both groups as compared to baseline values. Laser + EX effectively decreased VAS (mean difference -6.5, p = 0.01) and NDI scores after (mean difference -41.3, p = 0.01) 4 weeks of treatment compared to PL + EX. Conclusion: Class IV laser combined with exercise is effective treatment for patients with CNP as compared to PL + EX therapy. The combination of laser + EX effectively increased functional activity and reduced pain after 4 weeks of treatment.

Keywords: chronic neck pain, class IV laser, exercises, neck disability index, visual analogue scale

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Authors: Kherafa Abdennasser

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The application of Information and Communication Technologies (ICT) to the training area led to the creation of this new reality called E-learning. That last one is described like the marriage of multi- media (sound, image and text) and of the internet (diffusion on line, interactivity). Distance learning became an important totality for training and that last pass in particular by the setup of a distance learning platform. In our memory, we will use an open source platform named Dokeos for the management of a distance training of GPS called e-GPS. The learner is followed in all his training. In this system, trainers and learners communicate individually or in group, the administrator setup and make sure of this system maintenance.

Keywords: ICT, E-learning, learning plate-forme, Dokeos, GPS

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Authors: Arpan Upadhyaya, Sunaina Kuknor

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The paper examines the succession management strategies and the preparation level of heirs in the context of family-owned educational institutions in Nepal. Sixteen in-depth, semi-structured interviews with the institution's leader were conducted. The study's findings show the lack of awareness about the importance of succession planning among the institution owners due to the availability of limited resources. The paper also provides some insights into how family ownership and management are done and the lack of formal processes in succession management strategies. It will aid researchers in considering the societal perspective of the successor, which is also a significant worry.

Keywords: effective plans, family business, interest, leadership, successor

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Authors: Aslı Yörük, Mevla Yahya, Banu Tavat

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It is well established that bilinguals outperform monolinguals on executive function tasks. However, the effects of bilingualism on prospective memory (PM), which also requires executive functions, have not been investigated vastly. This study aimed to compare bi and monolingual participants' PM performance in focal and non-focal PM tasks. Considering that bilinguals have greater executive function abilities than monolinguals, we predict that bilinguals’ PM performance would be higher than monolinguals on the non-focal PM task, which requires controlled monitoring processes. To investigate these predictions, we administered the focal and non-focal PM task and measured the PM and ongoing task performance. Forty-eight Turkish-English bilinguals residing in North Macedonia and forty-eight Turkish monolinguals living in Turkey between the ages of 18-30 participated in the study. They were instructed to remember responding to rarely appearing PM cues while engaged in an ongoing task, i.e., spatial working memory task. The focality of the task was manipulated by giving different instructions for PM cues. In the focal PM task, participants were asked to remember to press an enter key whenever a particular target stimulus appeared in the working memory task; in the non-focal PM task, instead of responding to a specific target shape, participants were asked to remember to press the enter key whenever the background color of the working memory trials changes to a specific color (yellow). To analyze data, we performed a 2 × 2 mixed factorial ANOVA with the task (focal versus non-focal) as a within-subject variable and language group (bilinguals versus monolinguals) as a between-subject variable. The results showed no direct evidence for a bilingual advantage in PM. That is, the group’s performance did not differ in PM accuracy and ongoing task accuracy. However, bilinguals were overall faster in the ongoing task, yet this was not specific to PM cue’s focality. Moreover, the results showed a reversed effect of PM cue's focality on the ongoing task performance. That is, both bi and monolinguals showed enhanced performance in the non-focal PM cue task. These findings raise skepticism about the literature's prevalent findings and theoretical explanations. Future studies should investigate possible alternative explanations.

Keywords: bilingualism, executive functions, focality, prospective memory

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Authors: Aneta Daniel

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The subject of the study is the exploration of the origins and dynamics of the development of language studies, which have been labelled as neurolinguistics. It is worth mentioning that the origins of neurolinguistics are to be found in the research conducted by German scientists before the Second World War in Breslau Universität (presently Wroclaw). The dominant figure in these studies was professor Carl Wernicke, whose students continued and creatively developed projects of their master within this area. Professor Carl Wernicke, a German physician, anatomist, psychiatrist, and neuropathologist, is primarily known for his influential research on aphasia. His research, as well as those conducted by professor Paul Broca, has led to breakthroughs in the location of brain functions, particularly speech. Years later the theses of the pioneers of cognitive neurology (Carl Wernicke and Paul Broca) were developed by other neurolinguists. The main objective of the investigation is the reconstruction of the group of scientists –the students of Carl Wernicke– who contributed to the development of neurolinguistics. The scholars were mainly neurologists and psychiatrists and dealt with the branch of science that had not been named neurolinguistics at that time. The profiles of the scholars will be analysed and presented as the members of the group of researchers who have contributed to the breakthroughs in psychology and neuroscience. The research material consists of archival records documenting the research of professor Carl Wernicke and the researchers from Breslau (presently Wroclaw) which is one of the fastest growing cities in Europe. In 1870, when Carl Wernicke became the medical doctor, Breslau was full of cultural events: festivals and circus shows were held in the city center. Today we can come back to these events due to 'Breslauer Zeitung (1870)', which precisely describes all the events that took place on particular days. It is worth noting that those were the beginnings of antisemitism in Breslau. Many theses and articles that have survived in the libraries in Wroclaw and all over the world contribute to the development of neuroscience. The history of research on the brain and speech analysis, including the history of psychology and neuroscience, areas from which neurolinguistics is derived, will be presented.

Keywords: Aphasia, brain injury, Carl Wernicke, language, neurolinguistics

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Authors: Ani Kojoyan

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The Syrian refugee crisis has been a matter of worldwide concern during the recent years. And though refugees’ problems are contextualized in terms of time and space, the refugee crisis still remains a global issue to discuss. Since the start of the conflict, Armenia has welcomed thousands of Syrian refugees too. Taking into consideration Armenia’s current socio-economic and geopolitical situation, the flow of refugees is a challenge both for the country and for refugees themselves. However, these people are not simply refugees from Syria, they are Syrian-Armenian refugees; people whose ancestors were survivals of the Armenian Genocide, perpetrated by the Ottoman Turks in 1915, people whose ancestors became refugees a century ago in Syria and now, ironically, a century later they follow their ancestors’ paths, turning into refugees themselves in their historical homeland, facing various difficulties, among them socio-economic, socio-ideological, and identity and gender issues, the latter being the main topic of discussion in the present paper. The situation presented above makes us discuss certain questions within this study: how do Syrian-Armenian refugees define themselves and their status? Which are their gender roles in the socio-economic context? How do social and economic challenges re-shape Syrian-Armenian women refugees’ identities? The study applies qualitative research methods of analysis, which includes semi-structured and in-depth interviews with 15 participants (18-25, 26-40 age groups), and two focus group works, involving 8 participants (18-35 age group) for each focus group activity. The activities were carried out in October 2016, Yerevan, Armenia. The study also includes Secondary Data Analysis. In addition, in order to centralize refugee women’s experiences and identity issues, the study adopts a qualitative lens from a feminist standpoint position. It is based on the assumption that human activity structures and limits understanding, and that the distorted comprehension of events or activities has emerged from the male-oriented dominant judgement which can be discovered through uncovering the understanding of the situation from women’s activity perspectives. The findings suggest that identity is dynamic, complex, over-changing and sensitive to time and space, gender and class. The process of re-shaping identity is even more complicated and multi-layered and is based on internal and external factors, conditioned by individual and collective needs and interests. Refugees are mostly considered as people who lost their identity in the past since they have no longer connection anywhere and try to find it in the present. In turn, female refugees, being a more vulnerable class, go through more complicated identity re-formulating discourse negotiations. They stand between the borders of the old and new, borders of lost and re-found selves, borders of creating and self-fashioning, between illusions and the challenging reality. Particularly, refugee women become more sensitive within the discourses of the private and the public domains: some of them try to create a ‘new-self’, creating their space in a new society, whereas others try to negotiate their affective/emotional labour within their own family domains.

Keywords: feminist standpoint position, gender, identity, refugee studies, Syrian-Armenian women refugees

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Authors: Rushiraj Heshi, Smriti Bhandari

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Master Data Management requires creation of Central repository, applying constraints on Repository and designing processes to manage data. Designing of Repository, constraints on repository and business processes is very tedious and time consuming task for large Enterprise. Hence Visual Repository, constraints and Process (Workflow) modeling is the most critical step in Master Data Management.In this paper, we realize a Visual Modeling tool for implementing Repositories, Constraints and Processes based on Eclipse Plugin using GMF/EMF which follows principles of Model Driven Engineering (MDE).

Keywords: EMF, GMF, GEF, repository, constraint, process

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Authors: Ruedee Niyomrath

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This research aimed at surveying the local red clay raw material sources in Samut Songkram province, Thailand to test the physical and chemical properties of the local red clay, including to find the approach to develop the local red clay properties for ceramic production. The findings of this research would be brought to apply in the ceramic production industry of the country all at the upstream level which was the community in the raw material source, at the mid water level which was the ceramic producer and at the downstream level which was the distributor and the consumer as well as the community producer who would apply them to their identity and need of the community business.

Keywords: chemical properties of red clay, physical properties of red clay, ceramic production, red clay product

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Authors: P. Ayawei, A. D. Spiff

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It is certain that most African diasporans have experienced several types of traumas, which have conjured unprecedented psychological disorders needing adequate psychomorphological psychometrics. However, slavery was a long-term, multidimensional experience involving black victimization as well as effective black coping. In assessing, collecting, and analyzing the needed data, we first identify a group that has experienced a jolting, unpredictable, and monstrous assault. Second, we assess the depth of the trauma and an unambiguous period that marks the termination of the trauma using the alliterational psychomorphological psychometrics deca perimeter.

Keywords: slavery, Diaspora, Africa, psychomorphology, psychometrics, ancestry, disorder, phobias and trauma

Procedia PDF Downloads 51

Authors: A. Priyanka, Sunil Kumar Kainoor, Parinitha Nayaka

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Introduction: Ever since the ancient times, rape and other sexual offences are considered to be heinous crimes. Rape is not just another word in the dictionary, but it is the most barbaric act of violence committed with sex being the weapon. Rape is among the highest forms of crime experienced by women and children in all sectors of the society. In recent years, there has been an alarming rise in ratio of rape in India. The burden of such crimes on the society is very huge. The venereal diseases are the worst consequence along with unwanted pregnancies. Aims and Objectives: To determine the socio-demographic profile of the survivors of sexual offences reported to Dept. of Forensic Medicine of a South Indian medical college. Material methods: This retrospective study was conducted in the Department of Forensic Medicine of Raichur Institute of Medical Sciences, Raichur, Karnataka, India. Only survivors of sexual offences cases were included in the study group. Examination of all survivors was carried out by doctors of the said Department. Study period is one year six months, January 2015 to June 2016. Results/ case history: In total 140 cases of sexual offences were examined during study period of which the total survivors accounted to 62.85% i.e. 88 cases. Of the 88 survivors, 61 (69.31%) were registered under POCSO Act. The most affected age group of victims was 10-18 years in 59 (67%) cases. 61% were in acquaintance with the assailants, 18% were classmates/ friends, 13% of accused were Family members/ Relatives, 8% were strangers. 85% of the survivors were hailing from rural setup, while 15% were from urban. 60.65% of the survivors were students, 37.7% were doing Coolie/ Agricultural works. Conclusion: Delay in reporting of cases resulted in loss of vital physical evidences as no concrete report could be generated from the forensic lab after examination of specimens thus there should be coordination among doctors, forensic experts and investigating agency. It is worth mentioning that though a large number of cases of sexual offences are reported as rape many among them are consented acts and hence definite evidence of forceful sexual intercourse is lagging.

Keywords: consensual sex, India, POCSO Act- 2012, India, pregnancy, rape, sexual offence

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

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

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

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