Search results for: systematic analysis

Authors: Misbah Nizamani, Saira Malik

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Introduction: Bariatric surgery is the most effective treatment for patients suffering from morbid obesity. Laparoscopic sleeve gastrectomy (LSG) accounts for over 50% of total bariatric procedures. The aim of our meta-analysis is to investigate the effectiveness and safety of Enhanced Recovery After Surgery (ERAS) protocols for patients undergoing laparoscopic sleeve gastrectomy. Method: To gather data, we searched PubMed, Google Scholar, ScienceDirect, and Cochrane Central. Eligible studies were randomized controlled trials and cohort studies involving adult patients (≥18 years) undergoing bariatric surgeries, i.e., Laparoscopic sleeve gastrectomy. Outcome measures included LOS, postoperative narcotic usage, postoperative pain score, postoperative nausea and vomiting, postoperative complications and mortality, emergency department visits and readmission rates. RevMan version 5.4 was used to analyze outcomes. Results: Three RCTs and three cohorts with 1522 patients were included in this study. ERAS group and control group were compared for eight outcomes. LOS was reduced significantly in the intervention group (p=0.00001), readmission rates had borderline differences (p=0.35) and higher postoperative complications in the control group, but the result was non-significant (p=0.68), whereas postoperative pain score was significantly reduced (p=0.005). Total MME requirements became significant after performing sensitivity analysis (p= 0.0004). Postoperative mortality could not be analyzed on account of invalid data showing 0% mortality in two cohort studies. Conclusion: This systemic review indicated the effectiveness of the application of ERAS protocols in LSG in reducing the length of stay, post-operative pain and total MME requirements postoperatively, indicating the feasibility and assurance of its application.

Keywords: eras protocol, sleeve gastrectomy, bariatric surgery, enhanced recovery after surgery

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Authors: Modi Alsubaie, Willem Kuyken, Rebecca Abbott, Barnaby Dunn, Chris Dickens, Tina Keil, William Henley

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Background: Recently, there has been an increased interest in studying the effects of mindfulness-based interventions for people with psychological and physical problems. However, the mechanisms of action in these interventions that lead to beneficial physical and psychological outcomes have yet to be clearly identified. Purpose: The aim of this paper is to review, systematically, the evidence to date on the mechanisms of action in mindfulness interventions in populations with physical and/or psychological conditions. Method: Searches of seven databases (PsycINFO, Medline (Ovid), Cochrane Central Register of Controlled Trials, EMBASE, CINAHL, AMED, ClinicalTrials.gov) were undertaken in June 2014 and July 2015. We evaluated to what extent the studies we identified met the criteria suggested by Kazdin for establishing mechanisms of action within a psychological treatment (2007, 2009). Results: We identified four trials examining mechanisms of mindfulness interventions in those with comorbid psychological and physical health problems and 14 in those with psychological conditions. These studies examined a diverse range of potential mechanisms, including mindfulness and rumination. Of these candidate mechanisms, the most consistent finding was that greater self-reported change in mindfulness mediated superior clinical outcomes. However, very few studies fully met the Kazdin criteria for examining treatment mechanisms. Conclusion: There was evidence that global changes in mindfulness are linked to better outcomes. This evidence pertained more to interventions targeting psychological rather than physical health conditions. While there is promising evidence that MBCT/MBSR intervention effects are mediated by hypothesised mechanisms, there is a lack of methodological rigour in the field of testing mechanisms of action for both MBCT and MBSR, which precludes definitive conclusions.

Keywords: MBCT, MBSR, mechanisms, physical conditions, psychological conditions, systematic review

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Authors: M. Vassou, A. Karasimos

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A primary concern in the field of Second Language Acquisition (SLA) research is to determine the innate mechanisms of second language learning and acquisition through the systematic study of a learner's interlanguage. Errors emerge while a learner attempts to communicate using the target-language and can be seen either as the observable linguistic product of the latent cognitive and language process of mental representations or as an indispensable learning mechanism. Therefore, the study of the learner’s erroneous forms may depict the various strategies and mechanisms that take place during the language acquisition process resulting in deviations from the target-language norms and difficulties in communication. Mapping the erroneous utterances of a late adult learner in the process of acquiring Greek as a second language constitutes one of the main aims of this study. For our research purposes, we created an error-tagged learner corpus composed of the participant’s written texts produced throughout a period of a 4- year instructed language acquisition. Error analysis and interlanguage theory constitute the methodological and theoretical framework, respectively. The research questions pertain to the learner's most frequent errors per linguistic category and per year as well as his choices concerning the Greek Article System. According to the quantitative analysis of the data, the most frequent errors are observed in the categories of the stress system and syntax, whereas a significant fluctuation and/or gradual reduction throughout the 4 years of instructed acquisition indicate the emergence of developmental stages. The findings with regard to the article usage bespeak fossilization of erroneous structures in certain contexts. In general, our results point towards the existence and further development of an established learner’s (inter-) language system governed not only by mother- tongue and target-language influences but also by the learner’s assumptions and set of rules as the result of a complex cognitive process. It is expected that this study will contribute not only to the knowledge in the field of Greek as a second language and SLA generally, but it will also provide an insight into the cognitive mechanisms and strategies developed by multilingual learners of late adulthood.

Keywords: Greek as a second language, error analysis, interlanguage, late adult learner

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Authors: Ryo Sato

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The United States and many other countries witness alarmingly low voting rates among youths, skewing democratic representation. Many scholars and pundits have ascribed to this trend young voters' laziness, indifference, and self-centeredness and placed blame on them. However, a growing body of research is focusing on structural barriers to voting, which are defined as built-in obstacles lying in electoral laws and procedures. Drawing on national survey data from 891 young adults in 2020 and extant literature on structural barriers to voting, the project aims to develop a framework for analyzing systematic obstacles to voting experienced by young people and offer tangible policy recommendations. The preliminary findings presented at this conference include an intersectional analysis of the survey data, focusing on how different social categories — race, gender, socioeconomic status, immigration status, and others — in combination create unique voting experiences and barriers. This project offers a critical framework to combat the individualized understanding of low voting rates among youths and inform pathways to functional democracy.

Keywords: youth voting behavior, structural barriers, intersectionality, democratic participation, S

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Authors: Mateusz Bilski, Jakub Klas, Emilia Kowalczyk, Sylwia Koziej, Katarzyna Kulszo, Ludmiła Grzybowska- Szatkowska

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Background: Liver metastases are a common complication of primary solid tumors and sig-nificantly reduce patient survival. In the era of increasing diagnosis of oligometastatic disease and oligoprogression, methods of local treatment of metastases, i.e. MDT, are becoming more important. Implementation of such treatment can be considered for liver metastases, which are a common complication of primary solid tumors and significantly reduce patient survival. To date, the mainstay of treatment for oligometastatic disease has been surgical resection, but not all patients qualify for the procedure. As an alternative to surgical resection, radiotherapy techniques have become available, including stereotactic body radiation therapy (SBRT) or high-dose interstitial brachytherapy (iBT). iBT is an invasive method that emits very high doses of radiation from the inside of the tumor to the outside. This technique provides better tumor coverage than SBRT while having little impact on surrounding healthy tissue and elim-inates some concerns involving respiratory motion. Methods: We conducted a systematic re-view of the scientific literature on the use of brachytherapy in the treatment of liver metasta-ses from 2018 - 2023 using PubMed and ResearchGate browsers according to PRISMA rules. Results: From 111 articles, 18 publications containing information on 729 patients with liver metastases were selected. iBT has been shown to provide high rates of tumor control. Among 14 patients with 54 unresectable RCC liver metastases, after iBT LTC was 92.6% during a median follow-up of 10.2 months, PFS was 3.4 months. In analysis of 167 patients after treatment with a single fractional dose of 15-25 Gy with brachytherapy at 6- and 12-month follow-up, LRFS rates of 88,4-88.7% and 70.7 - 71,5%, PFS of 78.1 and 53.8%, and OS of 92.3 - 96.7% and 76,3% - 79.6%, respectively, were achieved. No serious complications were observed in all patients. Distant intrahepatic progression occurred later in patients with unre-sectable liver metastases after brachytherapy (PFS: 19.80 months) than in HCC patients (PFS: 13.50 months). A significant difference in LRFS between CRC patients (84.1% vs. 50.6%) and other histologies (92.4% vs. 92.4%) was noted, suggesting a higher treatment dose is necessary for CRC patients. The average target dose for metastatic colorectal cancer was 40 - 60 Gy (compared to 100 - 250 Gy for HCC). To better assess sensitivity to therapy and pre-dict side effects, it has been suggested that humoral mediators be evaluated. It was also shown that baseline levels of TNF-α, MCP-1 and VEGF, as well as NGF and CX3CL corre-lated with both tumor volume and radiation-induced liver damage, one of the most serious complications of iBT, indicating their potential role as biomarkers of therapy outcome. Con-clusions: The use of brachytherapy methods in the treatment of liver metastases of various cancers appears to be an interesting and relatively safe therapeutic method alternative to sur-gery. An important challenge remains the selection of an appropriate brachytherapy method and radiation dose for the corresponding initial tumor type from which the metastasis origi-nated.

Keywords: liver metastases, brachytherapy, CT-HDRBT, iBT

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Authors: G. Ramya

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Value engineering is a systematic approach, widely used to optimize the design or process or product in the designing stage. It used to achieve the client's obligation by increasing the functionality and attain the targeted cost in the cost planning. Value engineering effectiveness and benefits decrease along with the progress of the project since the change in the scope of the work and design will account for more cost all along the lifecycle of the project. Integrating the value engineering with other project management activities will promote cost minimization, client satisfaction, and ensure early completion of the project in time. Previous research studies suggested that value engineering can integrate with other project delivery activities, but research studies unable to frame a model that collaborates the project management activities with the job plan of value engineering approach. I analyzed various project management activities and their synergy between each other. The project management activities and processes like a)risk analysis b)lifecycle cost analysis c)lean construction d)facility management e)Building information modelling f)Contract administration, collaborated, and project delivery model planned along with the RIBA plan of work. The key outcome of the research is a value-driven project delivery model, which will succeed in dealing with the economic impact, constraints and conflicts arise due to the COVID-19 outbreak in the Indian construction sector. Benefits associated with the structured framework is construction project delivery that ensures early contractor involvement, mutual risk sharing, and reviving the project with a cost overrun and delay back on track ,are discussed. Keywords: Value-driven project delivery model, Integration, RIBA plan of work Themes: Design Economics

Keywords: value-driven project delivery model, Integration, RIBA

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Authors: Anish Desai, Reshmi Pillai, Nilesh Mahajan, Hitesh Chopra, Vishal Mahajan, Ajay Grover, Ashish Kohli

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Surgical Site Infection (SSI) is hospital acquired infection of growing concern. This study presents the efficacy and cost-effectiveness of triclosan-coated suture, in reducing the burden of SSI in India. Methodology: A systematic literature search was conducted for economic burden (1998-2018) of SSI and efficacy of triclosan-coated sutures (TCS) vs. non-coated sutures (NCS) (2000-2018). PubMed Medline and EMBASE indexed articles were searched using Mesh terms or Emtree. Decision tree analysis was used to calculate, the cost difference between TCS and NCS at private and public hospitals, respectively for 7 surgical procedures. Results: The SSI range from low to high for Caesarean section (C-section), Laparoscopic hysterectomy (L-hysterectomy), Open Hernia (O-Hernia), Laparoscopic Cholecystectomy (L-Cholecystectomy), Coronary artery bypass graft (CABG), Total knee replacement (TKR), and Mastectomy were (3.77 to 24.2%), (2.28 to 11.7%), (1.75 to 60%), (1.71 to 25.58%), (1.6 to 18.86%), (1.74 to 12.5%), and (5.56 to 25%), respectively. The incremental cost (%) of TCS ranged 0.1%-0.01% in private and from 0.9%-0.09% at public hospitals across all surgical procedures. Cost savings at median efficacy & SSI risk was 6.52%, 5.07 %, 11.39%, 9.63%, 3.62%, 2.71%, 9.41% for C-section, L-hysterectomy, O-Hernia, L-Cholecystectomy, CABG, TKR, and Mastectomy in private and 8.79%, 4.99%, 12.67%, 10.58%, 3.32%, 2.35%, 11.83% in public hospital, respectively. Efficacy of TCS and SSI incidence in a particular surgical procedure were important determinants of cost savings using one-way sensitivity analysis. Conclusion: TCS suture led to cost savings across all 7 surgeries in both private and public hospitals in India.

Keywords: cost Savings, non-coated sutures, surgical site infection, triclosan-coated sutures

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Authors: Roopali Kulkarni, Yuliya Khrypko

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A major problem in educational digital game design is that game developers are often focused on maintaining the fun and playability of an educational game, whereas educators are more concerned with the learning aspect of the game rather than its entertaining characteristics. There is a clear need to understand what key aspects of digital learning games make them an effective learning medium in tertiary education. Through a systematic literature review and content analysis, this paper identifies, evaluates, and summarizes twenty-three key attributes of digital games used in tertiary education and presents a summary digital game-based learning (DGBL) model for designing and evaluating an educational digital game of any genre that promotes effective learning in tertiary education. The proposed solution overcomes limitations of previously designed models for digital game evaluation, such as a small number of game attributes considered or applicability to a specific genre of digital games. The proposed DGBL model can be used to assist game designers and educators with creating effective and engaging educational digital games for the tertiary education curriculum.

Keywords: DGBL model, digital games, educational games, game-based learning, tertiary education

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Authors: Chidiebere C. Agoha, Armstong C. Awuzie, Chukwuebuka N. Onwubuariri, Joy O. Njoku

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Spatial analysis is a field of study that utilizes geographic or spatial information to understand and analyze patterns, relationships, and trends in data. It is characterized by the use of geographic or spatial information, which allows for the analysis of data in the context of its location and surroundings. It is different from non-spatial or aspatial techniques, which do not consider the geographic context and may not provide as complete of an understanding of the data. Spatial analysis is applied in a variety of fields, which includes urban planning, environmental science, geosciences, epidemiology, marketing, to gain insights and make decisions about complex spatial problems. This review paper explores definitions of spatial analysis from various sources, including examples of its application and different analysis techniques such as Buffer analysis, interpolation, and Kernel density analysis (multi-distance spatial cluster analysis). It also contrasts spatial analysis with non-spatial analysis.

Keywords: aspatial technique, buffer analysis, epidemiology, interpolation

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Authors: Mariam Arif

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The objective of the current study is to find out the electoral violence against women and its implications on their political participation. This paper is a qualitative study to get an in-depth analysis of the phenomenon. This study used questionnaires and interviews for findings. This paper attempts to study electoral violence and women in politics in Pakistan. The study concluded that women are subjected to different categories of violence defined as physical violence that involves sexual and bodily harm to a politically active woman or to people associated with her. Social and psychological violence includes class difference, stress, social limitations, family pressure and character assassination. Economic violence is defined as a systematic restriction of access to economic resources available to women thus hinder women active participation in politics (elections). All these violence against women in elections are threat to the integrity of the electoral process of the country that eventually affects women’s participation as voters, party candidates, election officials and political party leaders. It also undermines the free and fair democratic process. This qualitative paper shows a significant negative relationship between electoral violence and women participation in politics.

Keywords: elections, politics, violence, women

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Authors: Raad Nari, Maura Moriaty, Maha T. Barakat

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Introduction: Sodium-glucose co-transporter-2 (SGLT2) inhibitors are a new class of oral anti-diabetic drugs with a unique mechanism of action. They are used to improve glycaemic control in adults with type 2 diabetes by enhancing urinary glucose excretion. In the UAE, there has been certainly an increased use of these medications. As with any new medication, there are safety considerations related to their use in patients with type two diabetes. A retrospective study was conducted at the three main centres of the Imperial College London Diabetes Centre. Methodology: All patients in electronic database (Diamond) from October 2014 to October 2017 were included with a minimum of six months usage of sodium glucose co-transporter inhibitors that comprise canagliflozin, dapagliflozin and empagliflozin. There were 15 paired sample biochemical and clinical correlations. The analysis was done at the start of the study, three months and six months apart. SPSS version 24 was used for this study. Conclusion: This study of sodium glucose co-transporter-2 inhibitors used showed significant reductions in weight, glycated haemoglobin A1C, systolic and diastolic blood pressures. As the case with systematic reviews, there were similar changes in liver enzymes, raised total cholesterol, low density lipopoptein and high density lipoprotein. There was slight improvement in estimated glomerular filtration rate too. Our analysis also showed that they increased in the incidence of urinary tract symptoms and incidence of urinary tract infections.

Keywords: SGLT2 inhibitors dapagliflozin empagliflozin canagliflozin, adverse effects, amputation diabetic ketoacidosis DKA, urinary tract infection

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Authors: Phuc D. Nguyen, Kristy L. Hansen, Branko Zajamsek

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The existence of special characteristics of wind farm noise such as amplitude modulation (AM) contributes significantly to annoyance, which could ultimately result in sleep disturbance and other adverse health effects for residents living near wind farms. In order to detect and quantify this phenomenon, several methods have been developed which can be separated into three types: time-domain, frequency-domain and hybrid methods. However, due to a lack of systematic validation of these methods, it is still difficult to select the best method for identifying AM. Furthermore, previous comparisons between AM methods have been predominantly qualitative or based on synthesised signals, which are not representative of the actual noise. In this study, a comparison between methods for detecting and quantifying AM has been carried out. The results are based on analysis of real noise data which were measured at a wind farm in South Australia. In order to evaluate the performance of these methods in terms of detecting AM, an approach has been developed to select the most successful method of AM detection. This approach uses a receiver operating characteristic (ROC) curve which is based on detection of AM in audio files by experts.

Keywords: amplitude modulation, wind farm noise, ROC curve

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Authors: Nourah Almulhim

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This paper takes a critical discourse analysis (CDA) approach to investigate discourse and ideology in political blogs, focusing in particular on the Conservative Home blog from the UK’s current governing party. The Conservative party member’s discourse strategies as the blogger, alongside the discourse used by members of the public who reply to the blog in the below-the-lines comments, will be examined. The blog discourse reflects the writer's political identity and authorial voice. The analysis of the below-the-lines comments enables members of the public to engage in creating adversative positions, introducing different language users who bring their own individual and collective identities. These language users can play the role of news reporters, political analysts, protesters or supporters of a specific agenda and current socio-political topics or events. This study takes a qualitative approach to analyze the discriminatory context towards Islam/Muslims in ' The Conservative Home' blog. A cognitive approach is adopted and an analysis of dominant discourses in the blog text and the below-the-line comments is used. The focus of the study is, firstly, on the construction of self/ collective national identity in comparison to Muslim identity, highlighting the in-group and out-group construction. Second, the type of attitudes, whether feelings or judgments, related to these social actors as they are explicated to draw on the social values. Third, the role of discursive strategies in justifying and legitimizing those Islamophobic discriminatory practices. Therefore, the analysis is based on the systematic analysis of social actors drawing on actors, actions, and arguments to explicate identity construction and its development in the different discourses. A socio-semantic categorization of social actors is implemented to draw on the discursive strategies in addition to using literature to understand these strategies. An appraisal analysis is further used to classify attitudes and elaborate on core values in both genres. Finally, the grammar of othering is applied to explain how discriminatory dichotomies of 'Us' Vs. ''Them' actions are carried in discourse. Some of the key findings of the analysis can be summarized in two main points. First, the discursive practice used to represent Muslims/Islam as different from ‘Us’ are different in both genres as the blogger uses a covert voice while the commenters generally use an overt voice. This is to say that the blogger uses a mitigated strategy to represent the Muslim identity, for example, using the noun phrase ‘British Muslim’ but then representing them as ‘radical’ and ‘terrorists'. Contrary to this is in below the lines comments, where a direct strategy with an active declarative voice is used to negatively represent the Muslim identity as ‘oppressors’ and ‘terrorists’ with no inclusion of the noun phrase ‘British Muslims’. Second, the negotiation of the ‘British’ identity and values, such as culture and democracy, are prominent in the comment section as being unique and under threat by Muslims, while in the article, these standpoints are not represented.

Keywords: xenophobia, blogs, identity, critical discourse analysis

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Authors: Naif A. Haddad

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Greek, Hellenistic and Roman theatre heritage are exposed to multiple risks at varied times or simultaneously. There is no single reason why a theatre building becomes ‘at risk’, as each case has different circumstances which have led to the theatre building decay. There are complicated processes of destruction and distress that show divergence in theatre building materials' decay. Theatre modern use for cultural performances causes much of the risks concerning the physical structure and authenticity of theatre sites. In addition, there are some deterioration and deformations due to previous poor quality restorations and interventions through related excavation and conservation programmes as also risks to authenticity due to new additions. For preventive conservation, theatre natural and anthropogenic risks management can provide a framework for decision making. These risks to ancient theatre heritage may stem from exposure to one or more risk or synergy of many factors. We, therefore, need to link the theatre natural risks to the risks that come from anthropogenic factors associated with social and economic development. However, this requires a holistic approach, and systematic methodology for understanding these risks from various sources while incorporating specific actions, planning and strategies for each specific risk. Elaborating on recent relevant studies, and ERATO and ATHENA EU projects for ancient theaters and odea and general surveys, this paper attempts to discuss the main aspects of the ancient Greek, Hellenistic and Roman theatres risk related issues. Relevant case studies shall also be discussed and investigated to examine frameworks for risk mitigation, and related guidelines and recommendations that provide a systematic approach for sustainable management and planning in relation mainly to ‘compatible use’ of theatre sites.

Keywords: cultural heritage management, European ancient theatres projects, Anthropogenic risks mitigation, sustainable management and planning, preventive conservation, modern use, compatible use

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Authors: Dovile Petkeviciute-Barysiene

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Legal technologies not only create new ways for accessing and providing legal services but also transform the role of legal practitioners. Both lawyers and users of legal services expect automated solutions to outperform people with objectivity and impartiality. Although fairness of the automated decisions is crucial, research on assessing various characteristics of automated processes related to the perceived fairness has only begun. One of the major obstacles to this research is the lack of comprehensive understanding of what legal actions are automated and could be meaningfully automated, and to what extent. Neither public nor legal practitioners oftentimes cannot envision technological input due to the lack of general without illustrative examples. The aim of this study is to map decision making stages and automation levels which are and/or could be achieved in legal actions related to pre-trial and trial processes. Major legal decisions and judgments are identified during the consultations with legal practitioners. The dual-process model of information processing is used to describe cognitive processes taking place while making legal decisions and judgments during pre-trial and trial action. Some of the existing legal technologies are incorporated into the analysis as well. Several published automation level taxonomies are considered because none of them fit well into the legal context, as they were all created for avionics, teleoperation, unmanned aerial vehicles, etc. From the information processing perspective, analysis of the legal decisions and judgments expose situations that are most sensitive to cognitive bias, among others, also help to identify areas that would benefit from the automation the most. Automation level analysis, in turn, provides a systematic approach to interaction and cooperation between humans and algorithms. Moreover, an integrated map of legal decisions and judgments, information processing characteristics, and automation levels all together provide some groundwork for the research of legal technology perceived fairness and acceptance. Acknowledgment: This project has received funding from European Social Fund (project No 09.3.3-LMT-K-712-19-0116) under grant agreement with the Research Council of Lithuania (LMTLT).

Keywords: automation levels, information processing, legal judgment and decision making, legal technology

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Authors: Johanna Lundqvist

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Third cycle supervision is a multifaceted and complex task for supervisors in higher education. It progresses over several years and is affected by several proximal and distal factors. It can result in positive learning outcomes for doctoral students and high-quality publications. However, not all doctoral students thrive during their doctoral studies; nor do they all complete their studies. This is problematic for both the individuals themselves as well as society at large: doctoral students are valuable and important in current research, future research and higher education. The aim of this literature review is to elucidate what responsible third cycle supervision can include and be in practice. The question posed is as follows: according to recent literature, what is it that characterises responsible third cycle supervision in which doctoral students can thrive and develop their research knowledge and skills? A literature review was conducted, and the data gathered from the literature regarding responsible third cycle supervision was analysed by means of a thematic analysis. The analysis was inspired by the notion of responsible inclusion outlined by David Mitchell. In this study, the term literature refers to research articles and regulations. The results (preliminary) show that responsible third cycle supervision is associated with a number of interplaying factors (themes). These are as follows: committed supervisors and doctoral students; a clear vision and research problem; an individual study plan; adequate resources; interaction processes and constructive feedback; creativity; cultural awareness; respect and research ethics; systematic quality work and improvement efforts; focus on overall third cycle learning goals; and focus on research presentations and publications. Thus, responsible third cycle supervision can occur if these factors are realized in practice. This literature review is of relevance to evaluators, researchers, and management in higher education, as well as third cycle supervisors.

Keywords: doctoral student, higher education, third cycle supervisors, third cycle programmes

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Authors: Hilary Modir, Kyle Dutton, Michelle Swab, Shabnam Asghari

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Since its emergence, the cutaneous manifestations of COVID-19 have been documented in the literature. However, the majority are case reports with significant limitations in appraisal quality, thus leaving the role of dermatological manifestations of COVID-19 erroneously underexplored. The primary aim of this review was to systematically examine clinical patterns of dermatological manifestations as reported in the literature. This study was designed as a systematic review of case reports. The inclusion criteria consisted of all published reports and articles regarding COVID-19 in English, from September 1st, 2019, until June 22nd, 2020. The population consisted of confirmed cases of COVID-19 with associated cutaneous signs and symptoms. Exclusion criteria included research in planning stages, protocols, book reviews, news articles, review studies, and policy analyses. With the collaboration of a librarian, a search strategy was created consisting of a mixture of keyword terms and controlled vocabulary. Electronic databases searched were MEDLINE via PubMed, EMBASE, CINAHL, Web of Science, LILACS, PsycINFO, WHO Global Literature on Coronavirus Disease, Cochrane Library, Campbell Collaboration, Prospero, WHO International Clinical Trials Registry Platform, Australian and New Zealand Clinical Trials Registry, U.S. Institutes of Health Ongoing Trials Register, AAD Registry, OSF preprints, SSRN, MedRxiV and BioRxiV. The study selection featured an initial pre-screening of titles and abstracts by one independent reviewer. Results were verified by re-examining a random sample of 1% of excluded articles. Eligible studies progressed for full-text review by two calibrated independent reviewers. Covidence was used to store and extract data, such as citation information and findings pertaining to COVID-19 and cutaneous signs and symptoms. Data analysis and summarization methodology reflect the framework proposed by PRISMA and recommendations set out by Cochrane and Joanna Brigg’s Institute for conducting systematic reviews. The Oxford Centre for Evidence-Based Medicine’s level of evidence was used to appraise the quality of individual studies. The literature search revealed a total of 1221 articles. After the abstract and full-text screening, only 95 studies met the eligibility criteria, proceeding to data extraction. Studies were divided into 58% case reports and 42% series. A total of 833 manifestations were reported in 723 confirmed COVID-19 cases. The most frequent lesions were 23% maculopapular, 15% urticarial and 13% pseudo-chilblains, with 46% of lesions reporting pruritus, 16% erythema, 14% pain, 12% burning sensation, and 4% edema. The most common lesion locations were 20% trunk, 19.5% lower limbs, and 17.7% upper limbs. The time to resolution of lesions was between one and twenty-one days. In conclusion, over half of the reported cutaneous presentations in COVID-19 positive patients were maculopapular, urticarial and pseudo-chilblains, with the majority of lesions distributed to the extremities and trunk. As this review’s sample size only contained COVID-19 confirmed cases with skin presentations, it becomes difficult to deduce the direct relationship between skin findings and COVID-19. However, it can be correlated that acute onset of skin lesions, such as chilblains-like, may be associated with or may warrant consideration of COVID-19 as part of the differential diagnosis.

Keywords: COVID-19, cutaneous manifestations, cutaneous signs, general dermatology, medical dermatology, Sars-Cov-2, skin and infectious disease, skin findings, skin manifestations

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Authors: Y. Z. Gad

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Disorders of Sex Development (DSD) are defined as congenital conditions in which development of chromosomal, gonadal or anatomical sex is atypical. The DSD are relatively prevalent in Egypt. In spite of that, the relative rarity of the individual disease types or their molecular pathologies frequently resulted in reporting on single or few cases. This augmented the challenging nature of phenotype-genotype correlation in this disease group and its utilization in the management of such medical emergency. Through critical assessment of the published DSD reports, the current review aims at analyzing the clinical characteristics of the various DSD forms in relation to the underlying molecular pathologies. A systematic literature search was done in Pubmed, using relevant keywords (Egypt versus DSD, genital ambiguity or ambiguous genitalia, the old terms of 'intersex, hermaphroditism and pseudohermaphroditism', and a list of the DSD entities and their related genes). The search yielded 24 reports of molecular data in Egyptian patients presenting with ambiguous genitalia. However, only 21 publications fulfilled the criteria of inclusion of detailed clinical descriptions and definitive molecular diagnoses of individual patients. Curation of the data yielded a total of 53 cases that were ascertained from 40 families. Fifty-one patients present with ambiguous genitalia only while 2 had multiple congenital anomalies. Parental consanguinity was noted in 60% of cases. Sex of rearing at initial presentation was female in 75% and 60% in 46,XY and 46,XX DSD cases, respectively. The external genital phenotype in 2/3 of the 46,XY DSD cases showed moderate undermasculinization [Quigley scores 3 & 4] and 1/3 had severe presentations [scores 5 & 6]. For 46,XX subjects, 1 had severe virilization of the external genitalia while 8 had moderate phenotype. Hormonal data were inconclusive or contradictory to final diagnosis in a forth of cases. Collectively, 31 families [31/40, 77.5%] with 46,XY DSD had molecular defects in the genes, 5 alpha reductase 2 (SRD5A2) [12/31], 17 beta-hydroxysteroid dehydrogenase 3 [8/31], androgen receptor [7/31], Steroidogenic factor 1 [2/31], luteinizing hormone receptor [1/31], and fibroblast growth factor receptor 1 [1/31]. In a multiethnic study, 9 families afflicted with 46,XX DSD due to 11 beta hydroxylase (CYP11B1) deficiency were documented. Two recurrent mutations, G34R and N160D, in SRD5A2 were present, respectively, in 42 and 17% of cases. Similarly, 4 recurrent mutations resulted in 89% of the CYP11B1 presentations. In conclusion, this analysis highlights the importance of autosomal recessive inheritance and inbreeding among DSD presentations, the importance of founder effect in at least 2 disorders, the difficulties in relating the genotype with the indeterminate genital phenotype, the under-reporting of some DSD subtypes, and the notion that the reported mutational profiles among Egyptian DSD cases are relatively different from those reported in other ethnic groups.

Keywords: disorders of sex development, genital ambiguity, mutation, molecular diagnosis, Egypt

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Authors: Shih-Jen Feng, Nai-Chia Chao, Meng-Chi Shih, Chien-Chi Chang

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Today, Taiwan agriculture operates under small business scale with economic insufficiency, due to aging population, unproductiveness, inadequate systematic management, insufficient agro-economic scale, and cultivation on agro-education. Moreover, because of farming special working method (physical tiring, shackled weather condition), environment (asymmetric distribution information), hours devoted (unbalance wealth), the willingness for younger generation to delicate into agriculture farming is rare. Although government had provided policies to harmonize the existing problem, significant result is unseen. Living lab (LL) is a methodology approach to sense, prototype and validate complex solutions in real life context. This paper contributes an innovative interaction methodology by probing under implementation of diverse LL sector merging big data analysis utilizing rural redevelopment and revitalization plan of Wufeng.

Keywords: living lab approach, historic rural redevelopment, innovation model, innovation approach

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Authors: Despoina Andrioti Bygvraa, Ida-Maja Hassellöv, George Charalambous

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Exhaust gas cleaning systems, also known as scrubbers, are today widely used to allow for the use of High Sulphur Heavy Fuel Oil and still comply with the regulations limiting sulphur content in marine fuels. There are extensive concerns about environmental consequences, especially in the Baltic Sea, from the wide-scale use of scrubbers, as the wash water is acidic (ca pH 3) and contains high concentrations of toxic, carcinogenic, and mutagenic substances. The aim of this feasibility study is to investigate the potential adverse effects on seafarers’ health with the ultimate goal of raising awareness of chemical-related health and safety issues in the shipping environment. The project got funding from the Swedish Foundation. The team will extend previously compiled data on scrubber wash water concentrations of hazardous substances and pH to include the use of strong base in closed-loop scrubbers, and scoping assessment on handling and disposing practices. Based on the findings (a), a systematic review of risk assessment will follow to show the risk of exposures, the establishment of the hazardous levels for human health as well as the respective prevention practices. In addition, the researchers will perform (b) a systematic review to identify facilitators and barriers of the crew on compliance with the safe handling of chemicals. The study will run for 12 months, delivering (a) a risk assessment inventory with risk exposures and (b) a course description of safe handling practices. This feasibility study could provide valuable knowledge on how pollutants found in scrubbers should be considered from a human health perspective to facilitate evidence-based informed decisions in future technology- and policy development to make shipping a safer, healthier, and more attractive workplace.

Keywords: health and safety, seafarers, scrubbers, chemicals, risk exposures

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Authors: Angela Odero, Chrysoula Karathanasi, Michèle Baumann

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Integration of foreign communities has been a forefront issue in Luxembourg for some time now. The country’s continued progress depends largely on the successful integration of immigrants. The aim of our study was to analyze factors which intervene in the course of integration of Non-EU citizens through the discourse of Non-EU citizens residing in Luxembourg, who have signed the Welcome and Integration Contract (CAI). The two-year contract offers integration services to assist foreigners in getting settled in the country. Semi-structured focus group discussions with 50 volunteers were held in English, French, Spanish, Serbo-Croatian or Chinese. Participants were asked to talk about their integration experiences. Recorded then transcribed, the transcriptions were analyzed with the help of NVivo 10, a qualitative analysis software. A systematic and reiterative analysis of decomposing and reconstituting was realized through (1) the identification of predetermined categories (difficulties, challenges and integration needs) (2) initial coding – the grouping together of similar ideas (3) axial coding – the regrouping of items from the initial coding in new ways in order to create sub-categories and identify other core dimensions. Our results show that intervening factors include language acquisition, professional career and socio-cultural activities or events. Each of these factors constitutes different components whose weight shifts from person to person and from situation to situation. Connecting these three emergent factors are two elements essential to the success of the immigrant’s integration – the role of time and deliberate effort from the immigrants, the community, and the formal institutions charged with helping immigrants integrate. We propose a theoretical model where the factors described may be classified in terms of how they predispose, facilitate, and / or reinforce the process towards a successful integration. Measures currently in place propose one size fits all programs yet integrative measures which target the family unit and those customized to target groups based on their needs would work best.

Keywords: integration, integration services, non-eu citizens, qualitative analysis, third country nationals

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Authors: Phoutsathaphone Sibounheuang, Phayom Sookaneknun Olson, Chanuttha Ploylearmsang, Santiparp Sookaneknun, Chanthanom Manithip

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Patient satisfaction is an outcome that can be measured and used to improve diabetes care and management. There are limited instruments for assessing patient satisfaction covering the whole process of diabetes management. In this study, the questionnaire was developed with items pooled from a systematic review of qualitative studies of patients’ and healthcare providers’ perspectives in diabetes management. The questionnaire consists of 11 domains with 45 items. The Thai version was translated to Lao and then checked by back-translating it into Thai. We tested the questionnaire on 150 diabetes patients in Thailand and 150 in Lao People Democratic Republic (PDR). Validity was performed by factor analysis and Pearson correlation. Internal consistency reliability was estimated by calculating Cronbach’s alpha. The study was approved by the Mahasarakham University Ethics Committee, and the National Ethics Committee for Health Research, Lao PDR. The Thai and Lao versions showed the construct validity by principal component analysis. This consisted of 11 domains which account for 71.23% of the variance (Thai version) and 71.66% of the variance (Lao version) in the total patient satisfaction scores. The Kaiser-Meyer-Olkin (KMO) measures were 0.85 for the Thai version and 0.75 for the Lao version. The Bartlett tests of sphericity of both versions were significant (p < 0.001). The factor loadings of all items in both versions were > 0.40. The convergent validity of the Thai and Lao versions was 93.63% and 79.54% respectively. The discriminant validity for the Thai and Lao versions was 92.68% and 88.68% respectively. Cronbach’s alpha was 0.95 in both versions. The Patient Satisfaction Questionnaire (PSQ) in both versions had acceptable properties. This study has yielded evidence supporting the validity and reliability of both versions.

Keywords: construct validity, diabetes management, patient satisfaction, questionnaire development, reliability

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Authors: Hisham Arab Alkabeya, A. M. Hughes, J. Adams

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Background: People with Rheumatoid Arthritis (RA) continue to experience problems with hand function despite new drug advances and targeted medical treatment. Consequently, it is important to identify the factors that influence the impact of RA disease on hand function. This systematic review identified observational studies that reported factors that influenced the impact of RA on hand function. Methods: MEDLINE, EMBASE, CINAL, AMED, PsychINFO, and Web of Science database were searched from January 1990 up to March 2017. Full-text articles published in English that described factors related to hand functional disability in people with RA were selected following predetermined inclusion and exclusion criteria. Pertinent data were thoroughly extracted and documented using a pre-designed data extraction form by the lead author, and cross-checked by the review team for completion and accuracy. Factors related to hand function were classified under the domains of the International Classification of Functioning, Disability, and Health (ICF) framework and health-related factors. Three reviewers independently assessed the methodological quality of the included articles using the quality of cross-sectional studies (AXIS) tool. Factors related to hand function that was investigated in two or more studies were explored using a best-evidence synthesis. Results: Twenty articles form 19 studies met the inclusion criteria from 1,271 citations; all presented cross-sectional data (five high quality and 15 low quality studies), resulting in at best limited evidence in the best-evidence synthesis. For the factors classified under the ICF domains, the best-evidence synthesis indicates that there was a range of body structure and function factors that were related with hand functional disability. However, key factors were hand strength, disease activity, and pain intensity. Low functional status (physical, emotional and social) level was found to be related with limited hand function. For personal factors, there is limited evidence that gender is not related with hand function; whereas, conflicting evidence was found regarding the relationship between age and hand function. In the domain of environmental factors, there was limited evidence that work activity was not related with hand function. Regarding health-related factors, there was limited evidence that the level of the rheumatoid factor (RF) was not related to hand function. Finally, conflicting evidence was found regarding the relationship between hand function and disease duration and general health status. Conclusion: Studies focused on body structure and function factors, highlighting a lack of investigation into personal and environmental factors when considering the impact of RA on hand function. The level of evidence which exists was limited, but identified that modifiable factors such as grip or pinch strength, disease activity and pain are the most influential factors on hand function in people with RA. The review findings suggest that important personal and environmental factors that impact on hand function in people with RA are not yet considered or reported in clinical research. Well-designed longitudinal, preferably cohort, studies are now needed to better understand the causality between personal and environmental factors and hand functional disability in people with RA.

Keywords: factors, hand function, rheumatoid arthritis, systematic review

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Authors: Patrick O. Bobbie, Prince S. Attrams

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In recent times, the rapid change in new technologies has spurred up the way and manner records are handled in educational institutions. Also, there is a need for reliable access and ease-of use to these records, resulting in increased productivity in organizations. In academic institutions, such benefits help in quality assessments, institutional performance, and assessments of teaching and evaluation methods. Students in educational institutions benefit the most when advanced technologies are deployed in accessing records. This research paper discusses the use of biometric technologies coupled with smartcard technologies to provide a unique way of identifying students and matching their data to financial records to grant them access to restricted areas such as examination halls. The system developed in this paper, has an identity verification component as part of its main functionalities. A systematic software development cycle of analysis, design, coding, testing and support was used. The system provides a secured way of verifying student’s identity and real time verification of financial records. An advanced prototype version of the system has been developed for testing purposes.

Keywords: biometrics, smartcards, identity-verification, fingerprints

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Authors: A. T. Perez Fontenla, S. Sgobba, A. Bartkowska, Y. Askar, M. Dalemir Celuch, A. Newborough, M. Karppinen, H. Haalien, S. Deleval, S. Larcher, C. Charvet, L. Bruno, R. Trant

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The present study investigates the corrosion behavior of copper (Cu) based conducts predominantly brazed with Sil-Fos (self-fluxing copper-based filler with silver and phosphorus) within various cooling circuits of demineralized water across different particle accelerator components at CERN. The study covers a range of sample service time, from a few months to fifty years, and includes various accelerator components such as quadrupoles, dipoles, and bending magnets. The investigation comprises the established sample extraction procedure, examination methodology including non-destructive testing, evaluation of the corrosion phenomena, and identification of commonalities across the studied components as well as analysis of the environmental influence. The systematic analysis included computed microtomography (CT) of the joints that revealed distributed defects across all brazing interfaces. Some defects appeared to result from areas not wetted by the filler during the brazing operation, displaying round shapes, while others exhibited irregular contours and radial alignment, indicative of a network or interconnection. The subsequent dry cutting performed facilitated access to the conduct's inner surface and the brazed joints for further inspection through light and electron microscopy (SEM) and chemical analysis via Energy Dispersive X-ray spectroscopy (EDS). Brazing analysis away from affected areas identified the expected phases for a Sil-Fos alloy. In contrast, the affected locations displayed micrometric cavities propagating into the material, along with selective corrosion of the bulk Cu initiated at the conductor-braze interface. Corrosion product analysis highlighted the consistent presence of sulfur (up to 6 % in weight), whose origin and role in the corrosion initiation and extension is being further investigated. The importance of this study is paramount as it plays a crucial role in comprehending the underlying factors contributing to recently identified water leaks and evaluating the extent of the issue. Its primary objective is to provide essential insights for the repair of impacted brazed joints when accessibility permits. Moreover, the study seeks to contribute to the improvement of design and manufacturing practices for future components, ultimately enhancing the overall reliability and performance of magnet systems within CERN accelerator facilities.

Keywords: accelerator facilities, brazed copper conducts, demineralized water, magnets

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Authors: Bediru Abamecha

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Background: Domestic violence is a global problem that occurs regardless of culture, ethnicity or socio-economic class. It is known to be responsible for numerous hospital visits undertaken by women. Violence on pregnant women is a health and social problem that poses particular risks to the woman and her unborn child. Objective: The Objective of this study will be to assess prevalence of domestic violence and its correalates among pregnant women in Manna Woreda of Jimma Zone. Methods: Simple Random Sampling technique will be used to select 12 kebeles (48% of the study area) and Systematic Sampling will be used to reach to the house hold in selected kebeles in manna woreda of Jimma zone, south west Ethiopia from february 15-25, 2011. An in-depth interview will be conducted on Women affairs, police office and Nurses working and minimum of 4FGD with 6-8 members on pregnant women and selected male from the community. SPSS version 16.0 will be used to enter, clean and analyze the data. Descriptive statistics such as mean or median for continuous variables and percent for categorical variables will be made. Bivariate analysis will be used to check the association between independent variables and domestic violence. Variables found to have association with domestic violence will be entered to multiple logistic regressions for controlling the possible effect of confounders and finally the variables which had significance association will be identified on basis of OR, with 95% CI. All statistical significance will be considered at p<0.05. The qualitative data will be summarized manually and thematic analysis will be performed and finally both will be triangulated.

Keywords: ante natal care, ethiopian demographic and health survey, domestic violence, statistical package for social science

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Authors: Ifeanyi Adigwe

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The influence of television on adolescents is prevalent and widespread because television is a powerful sex educator for adolescents. This study examined the relationship between viewing sexual content on television and sexual behaviour of adolescents in public senior secondary schools in Lagos, Nigeria. The study employed a survey research design with a structured questionnaire as instrument. The multi-stage sampling technique was adopted. Firstly, purposive sampling was adopted in selecting 3 educational districts namely: Agege, Maryland, and Agboju. These educational districts were chosen for convenience and its wide coverage area of public senior secondary schools in Lagos State. Secondly, the researcher adopted systematic sampling to select the schools. The schools were listed in alphabetical order in each district and every 10th school were selected, yielding 13 schools altogether. A total of 501 copies of questionnaire were administered to the students and a total 491 copies of the questionnaire were retrieved. Only 453 copies of the questionnaire met the inclusion criteria and were used for analysis. Data were analyzed using descriptive statistics, Pearson Correlation, Principal components analysis, and regression analysis. Results of correlation analysis showed a positive and significant relationship between adolescent sexual belief and their preference for sexual content in television (r =0.117, N =453, p=0.13), viewing sexual content on television and adolescent sexual behavior, (r =-0.112, N =453, p<0.05), adolescent television preference and their preference for sexual content in television (r =0.328, N =453, p<0.05), adolescent television preference and adolescent’s sexual behavior (r=0.093, N =453, p<0.05). However, a negative but significant relationship exists between adolescent’s sexual knowledge and their sexual behavior (r=-122, N=453, p=0.0009). Pearson’s correlation between adolescents’ sexual knowledge and sexual behavior shows that there is a positive significant but strong relationship between adolescent’s sexual knowledge and their sexual behavior (r=0.967, N=453, p<0.05). The results also show that adolescent’s preference for sexual content in television informs them about their sexuality, development and sexual health. The descriptive and inferential analysis of data revealed that the interaction among adolescent sexual belief, knowledge and adolescents’ preference of sexual in television and its resultant effect on adolescent sexual behavior is apparent because sexual belief and norms about sex of an adolescent can induce his television preference of sexual content on television. The study concludes that exposure to sexual content in television can impact on adolescent sexual behaviour. There is no doubt that the actual outcome of television viewing and adolescent sexual behavior remains controversial because adolescent sexual behavior is multifaceted and multi-dimensional. Since behavior is learned overtime, the frequency of exposure and nature of sexual content viewed overtime induces and hastens sexual activity.

Keywords: adolescent sexual behavior, Nigeria, sexual belief, sexual content, sexual knowledge, television preference

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Authors: Nagore Guerra Bilbao, Clemente Lobato Fraile

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Mentoring is provided by professionals with a higher level of experience and competence as part of the professional development of a university faculty. This paper explores the characteristics of the mentoring provided by those teachers participating in the development of an active methodology program run at the University of the Basque Country: to examine and to analyze mentors’ performance with the aim of providing empirical evidence regarding its value as a lifelong learning strategy for teaching staff. A total of 183 teachers were trained during the first three programs. The analysis method uses a coding technique and is based on flexible, systematic guidelines for gathering and analyzing qualitative data. The results have confirmed the conception of mentoring as a methodological innovation in higher education. In short, university teachers in general assessed the mentoring they received positively, considering it to be a valid, useful strategy in their professional development. They highlighted the methodological expertise of their mentor and underscored how they monitored the learning process of the active method and provided guidance and advice when necessary. Finally, they also drew attention to traits such as availability, personal commitment and flexibility in. However, a minority critique is pointed to some aspects of the performance of some mentors.

Keywords: higher education, mentoring, professional development, university teachers

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

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

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

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Authors: K. Liagkouras, K. Metaxiotis

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Customer relationship management (CRM) systems in business are a reality of the contemporary business world for the last decade or so. Still, there are grey areas regarding the successful implementation and operation of CRM systems in business. This paper, through the systematic study of the CRM implementation paradigm, attempts to identify the most important challenges and opportunities that the CRM systems face in a rapidly changing business world.

Keywords: customer relationship management, CRM, business, literature review

Procedia PDF Downloads 512