Search results for: patient communication

Authors: Nkereke M. Essien

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The intention of this paper is to examine stress in the Educated Nigerian Accent of English (ENAE) with the aim of analyzing stress and rhythmic patterns of Nigerian English. Our aim also is to isolate differences and similarities in the stress patterns studied and also know what forms the accent of these Educated Nigerian English (ENE) which marks them off from other groups or English’s of the world, to ascertain and characterize it and to provide documented evidence for its existence. Nigerian stress and rhythmic patterns are significantly different from the British English stress and rhythmic patterns consequently, the educated Nigerian English (ENE) features more stressed syllables than the native speakers’ varieties. The excessive stressed of syllables causes a contiguous “Ss” in the rhythmic flow of ENE, and this brings about a “jerky rhythm’ which distorts communication. To ascertain this claim, ten (10) Nigerian speakers who are educated in the English Language were selected by a stratified Random Sampling technique from two Federal Universities in Nigeria. This classification belongs to the education to the educated class or standard variety. Their performance was compared to that of a Briton (control). The Metrical system of analysis was used. The respondents were made to read some words and utterance which was recorded and analyzed perceptually, statistically and acoustically using the one-way Analysis of Variance (ANOVA). The Turky-Kramer Post Hoc test, the Wilcoxon Matched Pairs Signed Ranks test, and the Praat analysis software were used in the analysis. It was revealed from our findings that the Educated Nigerian English speakers feature more stressed syllables in their productions by spending more time in pronouncing stressed syllables and sometimes lesser time in pronouncing the unstressed syllables. Their overall tempo was faster. The ENE speakers used tone to mark prominence while the native speaker used stress to mark pronounce, typified by the control. We concluded that the stress pattern of the ENE speakers was significantly different from the native speaker’s variety represented by the control’s performance.

Keywords: accent, Nigerian English, rhythm, stress

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Authors: Myoungsoon You, Heejung Son

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Background: In the current study, we investigated the effects of emotions induced by an infectious disease outbreak on the various protective behaviors taken during the crisis and on the perception after the crisis. The investigation was based on two psychological theories of appraisal tendency and action tendency. Methods: A total of 900 participants in South Korea who experienced the 2015 Middle East Respiratory Syndrome outbreak were sampled by a professional survey agency. To assess the influence of the emotions fear and anger, a regression approach was used. The effect of emotions on various protective behaviors and perceptions was observed using a hierarchical regression method. Results: Fear and anger induced by the infectious disease outbreak were both associated with increased protective behaviors during the crisis. However, the differences between the emotions were observed. While protective behaviors with avoidance tendency (adherence to recommendations, self-mitigation), were raised by both fear and anger, protective behaviors with approach tendency (information-seeking) were increased by anger, but not fear. Regarding the effect of emotion on the risk perception after the crisis, only fear was associated with a higher level of risk perception. Conclusions: This study confirmed the role of emotions in crisis protective behaviors and post-crisis perceptions regarding an infectious disease outbreak. These findings could enhance understanding of the public’s protective behaviors during infectious disease outbreaks and afterward risk perception corresponding to emotions. The results also suggested strategies for communicating with the public that takes into account emotions that are prominently induced by crises associated with disease outbreaks.

Keywords: crisis communication, emotion, infectious disease outbreak, protective behavior, risk perception

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Authors: Zulkifli Zainal Abidin, Ahmad Shahril Mohd Ghani

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Agent-based systems technology has been addressed as a new paradigm for conceptualizing, designing, and implementing software systems. Agents are sophisticated systems that act autonomously across open and distributed environments in solving problems. Nevertheless, it is impractical to rely on a single agent to do all computing processes in solving complex problems. An increasing number of applications lately require multiple agents to work together. A multi-agent system (MAS) is a loosely coupled network of agents that interact to solve problems that are beyond the individual capacities or knowledge of each problem solver. However, the network of MAS still requires a main system to govern or oversees the operation of the agents in order to achieve a unified goal. We had developed a fleet management system (FMS) in order to manage the fleet of agents, plan route for the agents, perform real-time data processing and analysis, and issue sets of general and specific instructions to the agents. This FMS should be able to perform real-time data processing, communicate with the autonomous surface vehicle (ASV) agents and generate bathymetric map according to the data received from each ASV unit. The first algorithm is developed to communicate with the ASV via radio communication using standard National Marine Electronics Association (NMEA) protocol sentences. Next, the second algorithm will take care of the path planning, formation and pattern generation is tested using various sample data. Lastly, the bathymetry map generation algorithm will make use of data collected by the agents to create bathymetry map in real-time. The outcome of this research is expected can be applied on various other multi-agent systems.

Keywords: autonomous surface vehicle, fleet management system, multi agent system, bathymetry

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Authors: Amna I. Shibeika, Batoul Y. Hittini, Tasneem B. Abd Bakri

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Regulation and integration of public policy, economy, insurance industry, education, and construction stakeholders are the main contributors to achieve sustainable development. Building environmental assessment methods were introduced in the field to address issues such as global warming and conservation of natural resources. In the UAE, Estidama framework with its associated Pearl Building Rating System (PBRS) has been introduced in 2010 to address and spread sustainability practices within the country’s fast-growing built environment. Based on literature review of relevant studies investigating different project characteristics that influence sustainability outcomes, this paper presents a conceptual framework for understanding the adoption of PBRS in UAE projects. The framework also draws on Diffusion of Innovations theory to address the questions of how the assessment method is chosen in the first place and what is the impact of PBRS on the multi-disciplinary design and construction processes. The study highlights the mandatory nature of the adoption of PBRS for government buildings as well as imbedding Estidama principles within Abu Dhabi building codes as key factors for raising awareness about sustainable practices. Moreover, several project-related elements are addressed to understand their relationship with the adoption process, including project team collaboration; communication and coordination; levels of commitment and engagement; and the involvement of key actors as sustainability champions. This conceptualization of the adoption of PBRS in UAE projects contributes to the growing literature on the adoption of energy assessment tools and addresses the UAE vision is to be at the forefront of innovative sustainable development by 2021.

Keywords: adoption, building assessment, design management, innovation, sustainability

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Authors: Bo Ning Lyu

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Blog assisted language learning (BALL) has been trialed by educators in language teaching with the development of Web 2.0 technology. Understanding the development trend of related research helps grasp the whole picture of the use of blog in language education. This paper reviews current research related to blogs enhanced language learning based on bibliometric analysis, aiming at (1) identifying the most frequently used keywords and their co-occurrence, (2) clustering research topics based on co-citation analysis, (3) finding the most frequently cited studies and authors and (4) constructing the co-authorship network. 330 articles were searched out in Web of Science, 225 peer-viewed journal papers were finally collected according to selection criteria. Bibexcel and VOSviewer were used to visualize the results. Studies reviewed were published between 2005 to 2016, most in the year of 2014 and 2015 (35 papers respectively). The top 10 most frequently appeared keywords are learning, language, blog, teaching, writing, social, web 2.0, technology, English, communication. 8 research themes could be clustered by co-citation analysis: blogging for collaborative learning, blogging for writing skills, blogging in higher education, feedback via blogs, blogging for self-regulated learning, implementation of using blogs in classroom, comparative studies and audio/video blogs. Early studies focused on the introduction of the classroom implementation while recent studies moved to the audio/video blogs from their traditional usage. By reviewing the research related to BALL quantitatively and objectively, this paper reveals the evolution and development trends as well as identifies influential research, helping researchers and educators quickly grasp this field overall and conducting further studies.

Keywords: blog, bibliometric analysis, language learning, literature review

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Authors: Chueh Chi-An, Chan Hui-Ya

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Background and Aim: National Health Insurance (NHI) Administration released a new reimbursement policy for hospital patients who received a superior discharge plan on April 1, 2016. Each case could be claimed 1,500 points for fee-of service with related documents. The policy is considered a solution to help reducing the crowding in the emergency department, the length of stay of hospital, unplanned readmission rate and unplanned ER visit. This study aim is to explore the effect of the new reimbursement policy for discharge planning service in a medical center. Methods: The discharge team explained to general wards the new policy and encouraged early assessment, communication and connecting to community care for patients. They stated the benefit from the policy and asked documenting for reimbursement claiming from April to May 2016. The imbursement fee of NHI declaration from June 2015 to October 2017 was collected. The indicators included hospital occupancy rate, hospital bed turnover rate, long-term hospitalization rate, and patients’ satisfaction were analyzed after the policy implemented. Results: The results showed that the amount of service declaration was increasing from 2 cases in February 2016 to 110 cases in October 2017, the application rate was increasing from 0.029% to 1.576% of all inpatient cases, and the average payment from NHI was around 148,500 NT dollars per month in 2017. There are no significant differences in the indicators among hospital occupancy rate, hospital bed turnover rate, long-term hospitalization rate, and patients’ satisfaction. Conclusion: To provide a good discharge plan require a specialized case manager, the new reimbursement policy is too complicated and the total fee-of-service hospital could claim is too limited to hiring one. The results suggest more strategies combine with the new reimbursement policy will be needed.

Keywords: discharge planning, reimbursement, unplanned ER visit, readmission rate

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Authors: Adel Al Hashlan

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Parent and family engagement plays a crucial role in supporting the success of students with special needs in educational settings. This paper explores the significance of parental involvement in special education, examining its impact on academic achievement, social-emotional development, and overall well-being. Meaningful collaboration between educators, parents, and families can promote positive outcomes for students with diverse learning needs. The study employs a mixed-methods approach, incorporating both qualitative and quantitative techniques. Data were collected through structured interviews, focus groups, and surveys involving students with special needs, their parents, and educators across diverse educational settings. The analysis identifies patterns, themes, and correlations to understand the impact of parent and family engagement on student outcomes. Major findings reveal that effective parent and family involvement initiatives, characterized by strong communication strategies, collaboration frameworks, and partnership-building approaches, significantly enhance students’ academic performance, social-emotional development, and overall well-being. The study also identifies common barriers to parental involvement, such as cultural differences and accessibility issues, and suggests strategies for overcoming these challenges. In conclusion, the study underscores the importance of systemic support and resource allocation to facilitate meaningful partnerships between schools and families. Ongoing research and professional development are crucial to enhancing the effectiveness of parent and family engagement initiatives in special education, ultimately maximizing student achievement and well-being.

Keywords: parental involvement, special education, student success, collaborative partnerships

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Authors: Olga Bernikova, Oleg Redkin

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Islamic Studies and the Arabic language are indivisible from each other starting from the appearance of Islam and formation of the Classical language. The present paper demonstrates correlation among linguistics and religion in historical perspective with regard to peculiarities of the Arabic language which distinguish it from the other prophetic languages. Islamic Studies and Linguistics are indivisible from each other starting from the invent of Islam and formation of the Classical language. In historical perspective, the Arabic language has been and remains a tool for the expression of Islamic rhetoric being a prophetic language. No other language in the world has preserved its stability for more than 14 centuries. Islam is considered to be one of the most important factors which secure this stability. The analysis and study of the text of Qurʾān are of special importance for those who study Islamic civilization, its role in the destinies of the mankind, its values and virtues. Without understanding of the polyphony of this sacred text, indivisible unity of its form and content it is impossible to understand social developments both in the present and the past. Since the first years of Islam Qurʾān had been in the center of attention of Muslim scholars, and in the center of attention of theologians, historians, philologists, jurists, mathematicians. Only quite recently it has become an object of analysis of the specialists of computer technologies. In Arabic and Islamic studies mediaeval texts i.e. textual documents are considered the main source of information. Hence the analysis of the multiplicity of various texts and finding of interconnections between them help to set scattered fragments of the riddle into a common and eloquent picture of the past, which reflects the state of the society on certain stages of its development. The text of the Qurʾān like any other phenomenon is a multifaceted object that should be studied from different points of view. As a result, this complex study will allow obtaining a three-dimensional image rather than a flat picture alone.

Keywords: Arabic, Islamic studies, linguistics, religion

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Authors: Takuro Kida, Yuichi Kida

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We show a base of the new trend of algorithm mathematically that treats a historical reason of continuous discrimination in the world as well as its solution by introducing new concepts of parallel world that includes an invisible set of errors as its companion. With respect to a matrix operator-filter bank that the matrix operator-analysis-filter bank H and the matrix operator-sampling-filter bank S are given, firstly, we introduce the detailed algorithm to derive the optimum matrix operator-synthesis-filter bank Z that minimizes all the worst-case measures of the matrix operator-error-signals E(ω) = F(ω) − Y(ω) between the matrix operator-input-signals F(ω) and the matrix operator-output signals Y(ω) of the matrix operator-filter bank at the same time. Further, feedback is introduced to the above approximation theory and it is indicated that introducing conversations with feedback does not superior automatically to the accumulation of existing knowledge of signal prediction. Secondly, the concept of category in the field of mathematics is applied to the above optimum signal approximation and is indicated that the category-based approximation theory is applied to the set-theoretic consideration of the recognition of humans. Based on this discussion, it is shown naturally why the narrow perception that tends to create isolation shows an apparent advantage in the short term and, often, why such narrow thinking becomes intimate with discriminatory action in a human group. Throughout these considerations, it is presented that, in order to abolish easy and intimate discriminatory behavior, it is important to create a parallel world of conception where we share the set of invisible error signals, including the words and the consciousness of both worlds.

Keywords: signal prediction, pseudo inverse matrix, artificial intelligence, conditional optimization

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Authors: Jeelka Ray

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Survey of the papers revealed that there is no practical design available for packaging machine based on Embedded system, so the need arose for the development of the prototype model. In this paper, author has worked on the development of an ARM7 based Embedded Controller for controlling the sequence of packaging machine. The unit is made user friendly with TFT and Touch Screen implementing human machine interface (HMI). The different system components are briefly discussed, followed by a description of the overall design. The major functions which involve bag forming, sealing temperature control, fault detection, alarm, animated view on the home screen when the machine is working as per different parameters set makes the machine performance more successful. LPC2478 ARM 7 Embedded Microcontroller controls the coordination of individual control function modules. In back gone days, these machines were manufactured with mechanical fittings. Later on, the electronic system replaced them. With the help of ongoing technologies, these mechanical systems were controlled electronically using Microprocessors. These became the backbone of the system which became a cause for the updating technologies in which the control was handed over to the Microcontrollers with Servo drives for accurate positioning of the material. This helped to maintain the quality of the products. Including all, RS 485 MODBUS Communication technology is used for synchronizing AC Drive & Servo Drive. These all concepts are operated either manually or through a Graphical User Interface. Automatic tuning of heaters, sealers and their temperature is controlled using Proportional, Integral and Derivation loops. In the upcoming latest technological world, the practical implementation of the above mentioned concepts is really important to be in the user friendly environment. Real time model is implemented and tested on the actual machine and received fruitful results.

Keywords: packaging machine, embedded system, ARM 7, micro controller, HMI, TFT, touch screen, PID

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Authors: Surachart Koyadun

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Introduction: Plasmodium knowlesi (P. knowlesi) malaria is a zoonotic disease that is classified as type 5 of human malaria. Commonly found in macaques (Macaca fascicularis) and (Macaca nemestrina), P. knowlesi is capable of resulting in both uncomplicated and severe malaria in humans. Situation of P. knowlesi malaria in Phang-Nga province for the past 3 years from 2020 – 2022 revealed no case report in 2020, however, a total of 14 cases had been reported in 2021 - 2022. This research aimed to 1) study the epidemiology of P. knowlesi, 2) examine the clinical manifestations of P. knowlesi patients, 3) analyze the ecology and entomology of P. knowlesi, and 4) analyze the diagnosis and treatment of P. knowlesi. Method: This research was a retrospective descriptive study/case report. The study was conducted in 14 patients with P. knowlesi malaria between 2021 and 2022 in 4 districts of Phang-Nga Province, Thailand including Thapput, Kapong, Takuapa and Khuraburi. Results: The study subjects of P. knowlesi malaria were all males. Most of them were working age groups as farmers and worked in forest or plantation areas. All had no history of blood transfusions. Most of the patients did not use mosquito nets and had a history of camping in the forest prior to the onset of fever. An analysis of all 14 sources of infection unveiled the area is home to macaques, and that area has detected Anopheles mosquito, which is the carrier of the disease. Majority of them got sick in the dry season of Thailand (December-April). The main symptoms brought to the hospital were fever, chills, headache, body aches. Laboratory findings on the first day of diagnosis were as follows: The white blood cell count was found within the normal range. In the proportion of white blood cells, eosinophils were found to be slightly higher than normal. Slight anemia was found on early examination. The platelet count was found to be below normal in all cases. Severely low platelet count (2,000 cells/mm3) was found in severe cases with multiple complications. No patient was found dead but 85.7% of complications were found, with acute renal failure being the most common. Patients with delayed diagnosis and treatment of malaria (inaccurate diagnosis or late access to the hospital) had the highest severity and complications than those who had seen the doctor since the first 3-4 days of illness or the screening of symptoms and risk history by the malaria clinic staff at vector-borne disease control unit. Conclusion and Recommendation: P. knowlesi malaria is an emerging infectious disease transmitted from animals to humans. There are challenges in epidemiology, entomology, ecology for effective surveillance, prevention and control. Early diagnosis and treatment would reduce complications and prevent death.

Keywords: malaria, plasmodium knowlesi, epidemiology, ecology, entomology, diagnosis, treatment

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Authors: Jeaha Yang, Ahmed Khan, Donna L. Rodela, Mohammed A. Qaudeer

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Traditional supply chain silos still exist today due to the difficulty of establishing trust between various partners and technological barriers across industries. Companies lose opportunities and revenue and inadvertently make poor business decisions resulting in further challenges. Blockchain technology can bring a new level of transparency through sharing information with a distributed ledger in a decentralized manner that creates a basis of trust for business. Blockchain is a loosely coupled, hub-style communication network in which trading partners can work indirectly with each other for simpler integration, but they work together through the orchestration of their supply chain operations under a coherent process that is developed jointly. A Blockchain increases efficiencies, lowers costs, and improves interoperability to strengthen and automate the supply chain management process while all partners share the risk. Blockchain ledger is built to track inventory lifecycle for supply chain transparency and keeps a journal of inventory movement for real-time reconciliation. State design patterns are used to capture the life cycle (behavior) of inventory management as a state machine for a common, transparent and coherent process which creates an opportunity for trading partners to become more responsive in terms of changes or improvements in process, reconcile discrepancies, and comply with internal governance and external regulations. It enables end-to-end, inter-company visibility at the unit level for more accurate demand planning with better insight into order fulfillment and replenishment.

Keywords: supply chain management, inventory trace-ability, perpetual inventory system, inventory lifecycle, blockchain, inventory consignment, supply chain transparency, digital thread, demand planning, hyper ledger fabric

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Authors: Sebastian Del Corral Winder, Kiriana Sanchez, Mixalis Poulakis, Samantha Gray

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This paper seeks to explore White privilege and Whiteness. Being White in the U.S. is often perceived as the norm and it brings significant social, economic, educational, and health privileges that often are hidden in social interactions. One quality of Whiteness has been its invisibility given its intrinsic impact on the system, which becomes only visible when paying close attention to White identity and culture and during cross-cultural interactions. The cross-cultural interaction provides an emphasis on differences between the participants and people of color are often viewed as “the other.” These interactions may promote an increased opportunity for discrimination and negative stereotypes against a person of color. Given the recent increase of violence against culturally diverse groups, there has been an increased sense of otherness and division in the country. Furthermore, the accent prestige theory has found that individuals who speak English with a foreign accent are perceived as less educated, competent, friendly, and trustworthy by White individuals in the United States. Using the consensual qualitative research (CQR) methodology, this study explored the cross-cultural dyad from the White individual’s perspective focusing on the psychotherapeutic relationship. The participants were presented with an audio recording of a conversation between a psychotherapist with a Hispanic accent and a patient with an American English accent. Then, the participants completed an interview regarding their perceptions of race, culture, and cross-cultural interactions. The preliminary results suggested that the Hispanic accent alone was enough for the participants to assign stereotypical ethnic and cultural characteristics to the individual with the Hispanic accent. Given the quality of the responses, the authors completed a secondary analysis to explore Whiteness and White privilege in more depth. Participants were found to be on a continuum in their understanding and acknowledgment of systemic racism; while some participants listed examples of inequality, other participants noted: “all people are treated equally.” Most participants noted their feelings of discomfort in discussing topics of cultural diversity and systemic racism by fearing to “say the ‘wrong thing.” Most participants placed the responsibility of discussing cultural differences with the person of color, which has been observed to create further alienation and otherness for culturally diverse individuals. The results indicate the importance of examining racial and cultural biases from White individuals to promote an anti-racist stance. The results emphasize the need for greater systemic changes in education, policies, and individual awareness regarding cultural identity. The results suggest the importance for White individuals to take ownership of their own cultural biases in order to promote equity and engage in cultural humility in a multicultural world. Future research should continue exploring the role of White ethnic identity and education as they appear to moderate White individuals’ attitudes and beliefs regarding other races and cultures.

Keywords: culture, qualitative research, whiteness, white privilege

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Authors: Krupali Mukeshkumar, Jinesh Shah

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Background: Bilateral Sagittal Split Osteotomy (BSSO), used for the correction of mandibular deformities, is a common oral and maxillofacial surgical procedure. Inferior alveolar nerve dysfunction is commonly reported post-operatively by patients as paresthesia or anesthesia. The current literature lacks a consensus on the incidence of inferior alveolar nerve dysfunction as patients are not routinely assessed pre and post-operatively with an objective assessment. The range of incidence varies from 9% to 85% of patients, with some authors arguing that 100% of patients experience nerve dysfunction immediately post-surgery. Systematic reviews have shown a difference between incidence rates at different follow-up periods using objective and subjective methods. Aim: To identify the incidence of inferior alveolar nerve dysfunction following BSSO. Gold standard: Nerve dysfunction incidence rates similar or lower than current literature of 83% day one post-operatively and 18.4% at one year follow up. Setting: A retrospective cross-sectional audit of patients treated between 2017-2019 at the Royal Stoke University Hospital, Maxillofacial and Orthodontic departments. Sample: All patients who underwent a BSSO (with or without le fort one osteotomy) between 2017–2019 were identified from the database. Patients with pre-existing neurosensory disturbance, those who had a genioplasty at the same time and those with no follow-up were excluded. The sample consisted of 121 patients, 37 males and 84 females between the ages of 17-50 years at the time of surgery. Methods: Clinical records of 121 cases were reviewed to assess the age, sex, type of mandibular osteotomy, status of the nerve during the surgical procedure, type of bony split and incidence of nerve dysfunction at follow-up appointments. The surgical procedure was carried out by three Maxillo-facial surgeons and follow-up appointments were carried out in the Orthodontic and Oral and Maxillo-facial departments. Results: 120 patients were treated to correct the mandibular facial deformity and 1 patient was treated for sleep apnoea. Seventeen patients had a mandibular setback and 104 patients had mandibular advancement. 68 patients reported inferior alveolar nerve dysfunction at one week following their surgery. Seventy-six patients had temporary paresthesia present between 2 weeks and 12 months post-surgery. 13 patients had persistent nerve dysfunction at 12 months, of which 1 had a bad bony split during the BSSO. The incidence of nerve dysfunction postoperatively was 6.6% after 1 day, 56.1% at 1 week, 62.8% at 2 weeks, 59.5% between 3-6 weeks, 43.0% between 8-16 weeks and 10.7% at 1 year. Conclusions: The results of this audit show a similar incidence rate to the research gold standard at the one-year follow-up. Future Recommendations: No changes to surgical procedure or technique are indicated, but a need for improved documentation and a standardized approach for assessment of post-operative nerve dysfunction would be beneficial.

Keywords: bilateral sagittal split osteotomy, inferior alveolar nerve, mandible, nerve dysfunction

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Authors: Akbar Gharbali, Ali Abbasian Ardekani, Afshin Mohammadi

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Introduction: Thyroid nodules have an incidence of 33-68% in the general population. More than 5-15% of these nodules are malignant. Early detection and treatment of thyroid nodules increase the cure rate and provide optimal treatment. Between the medical imaging methods, Ultrasound is the chosen imaging technique for assessment of thyroid nodules. The confirming of the diagnosis usually demands repeated fine-needle aspiration biopsy (FNAB). So, current management has morbidity and non-zero mortality. Objective: To explore diagnostic potential of automatic texture analysis (TA) methods in differentiation benign and malignant thyroid nodules by ultrasound imaging in order to help for reliable diagnosis and monitoring of the thyroid nodules in their early stages with no need biopsy. Material and Methods: The thyroid US image database consists of 70 patients (26 benign and 44 malignant) which were reported by Radiologist and proven by the biopsy. Two slices per patient were loaded in Mazda Software version 4.6 for automatic texture analysis. Regions of interests (ROIs) were defined within the abnormal part of the thyroid nodules ultrasound images. Gray levels within an ROI normalized according to three normalization schemes: N1: default or original gray levels, N2: +/- 3 Sigma or dynamic intensity limited to µ+/- 3σ, and N3: present intensity limited to 1% - 99%. Up to 270 multiscale texture features parameters per ROIs per each normalization schemes were computed from well-known statistical methods employed in Mazda software. From the statistical point of view, all calculated texture features parameters are not useful for texture analysis. So, the features based on maximum Fisher coefficient and the minimum probability of classification error and average correlation coefficients (POE+ACC) eliminated to 10 best and most effective features per normalization schemes. We analyze this feature under two standardization states (standard (S) and non-standard (NS)) with Principle Component Analysis (PCA), Linear Discriminant Analysis (LDA) and Non-Linear Discriminant Analysis (NDA). The 1NN classifier was performed to distinguish between benign and malignant tumors. The confusion matrix and Receiver operating characteristic (ROC) curve analysis were used for the formulation of more reliable criteria of the performance of employed texture analysis methods. Results: The results demonstrated the influence of the normalization schemes and reduction methods on the effectiveness of the obtained features as a descriptor on discrimination power and classification results. The selected subset features under 1%-99% normalization, POE+ACC reduction and NDA texture analysis yielded a high discrimination performance with the area under the ROC curve (Az) of 0.9722, in distinguishing Benign from Malignant Thyroid Nodules which correspond to sensitivity of 94.45%, specificity of 100%, and accuracy of 97.14%. Conclusions: Our results indicate computer-aided diagnosis is a reliable method, and can provide useful information to help radiologists in the detection and classification of benign and malignant thyroid nodules.

Keywords: ultrasound imaging, thyroid nodules, computer aided diagnosis, texture analysis, PCA, LDA, NDA

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Authors: Bruno Valverde Chahaira, Matheus Jeronimo Low Lopes, Marta Beatriz Tanaka Ferdinandi

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This paper proposes to dissect the meanings and / or directions of the State, in order, to present the State models to elaborate a conceptual framework about its function in the legal scope. To do so, it points out the possible contracts established between the State and the Society, since the general principles immanent in them can guide the models of society in force. From this orientation arise the contracts, whose purpose is by the effect to modify the status (the being and / or the opinion) of each of the subjects in presence - State and Society. In this logic, this paper announces the fiduciary contracts and “veredicção”(portuguese word) contracts, from the perspective of semiotics discourse (or greimasian). Therefore, studies focus on the issue of manifest language in unilateral and bilateral or reciprocal relations between the State and Society. Thus, under the biases of the model of the communicative situation and discourse, the guidelines of these contractual relations will be analyzed in order to see if there is a pragmatic sanction: positive when the contract is signed between the subjects (reward), or negative when the contract between they are broken (punishment). In this way, a third path emerges which, in this specific case, passes through the subject-third sector. In other words, the proposal, which is systemic in nature, is to analyze whether, since the contract of the welfare state is not carried out in the constitutional program on fundamental rights: education, health, housing, an others. Therefore, in the structure of the exchange demanded by the society according to its contractual obligations (others), the third way (Third Sector) advances in the empty space left by the State. In this line, it presents the modalities of action of the third sector in the social scope. Finally, the normative communication organization of these three subjects is sought in the pragmatic model of discourse, namely: State, Society and Third Sector, in an attempt to understand the constant dynamics in the Law and in the language of the relations established between them.

Keywords: access to justice, state, social rights, third sector

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Authors: Iris Xiaohong Quan, Sharon Qi, Kelly Tianqin Shi

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This study focuses on the critical role of insurance policies in a world grappling with increasing mental health challenges, as they significantly influence the dynamics of healthcare businesses and entrepreneurial ventures. The paper utilizes the mental health sector as a case to examine the impact of insurance policies on healthcare service providers, entrepreneurs, and individuals seeking mental health support. This paper addressed the following research questions: To what extent do changes in insurance reimbursement policies affect the accessibility and affordability of mental health services for patients, and how does this impact the overall demand for such services? What are the barriers and opportunities that mental health entrepreneurs face and what strategies and adaptations do mental health businesses employ when navigating the evolving landscape of insurance reimbursement policies? How do changes in insurance reimbursement policies, specifically related to mental health services, influence the financial viability and sustainability of mental health clinics and private practices? Employing a self-designed survey aimed at autism spectrum disorder (ASD) treatment companies, alongside two in-depth case studies and an analysis of pertinent insurance policies and documents, this research aims to elucidate the multifaceted influence of insurance policies on the mental health industry. The findings from this study reveal how insurance policies shape the landscape of mental health businesses and their operations. A total of 821 autism treatment organizations or offices were contacted by telephone between November 1, 2019, and January 31, 2020. About half of the offices (53.33%) were established in the past five years, and 80% were established in the past 15 years. There is a significant increase in the establishment of ABA service centers in the recent two decades as a result of autism insurance reform, the increasing social awareness of ASD, and the redefinition of autism. In addition, almost half of the ABA service providers we surveyed had a patient size ranging from 20 to 50 in the year when the residence state passed the legislation for autism insurance coverage. On average, an ABA service provider works with 5.3 insurance companies. This research find that insurance is the main source of revenue for most ABA service providers. However, our survey reveals that clients’ out of pocket payment has been the second main revenue sources. Despite the changes of regulations and insurance policies in all states, clients still have to pay a fraction of, if not all, the ABA treatment service fees out of pocket. This research shows that some ABA service providers seek federal and government funds and grants to support their services and businesses. Our further analysis with the in-depth case studies and other secondary data also indicate the rise of entrepreneurial startups in the mental health industry. Overall, this research sheds light on both the challenges and opportunities presented by insurance policies in the mental health sector, offering insights into the new industry landscape.

Keywords: entrepreneurship, healthcare policy, insurance policy, mental health industry

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Authors: Chahrazed Zouaoui

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In recent years, the volume of geospatial information is increasing due to the evolution of communication technologies and information, this information is presented often by geographic information systems (GIS) and stored on of spatial databases (BDS). The classical data mining revealed a weakness in knowledge extraction at these enormous amounts of data due to the particularity of these spatial entities, which are characterized by the interdependence between them (1st law of geography). This gave rise to spatial data mining. Spatial data mining is a process of analyzing geographic data, which allows the extraction of knowledge and spatial relationships from geospatial data, including methods of this process we distinguish the monothematic and thematic, geo- Clustering is one of the main tasks of spatial data mining, which is registered in the part of the monothematic method. It includes geo-spatial entities similar in the same class and it affects more dissimilar to the different classes. In other words, maximize intra-class similarity and minimize inter similarity classes. Taking account of the particularity of geo-spatial data. Two approaches to geo-clustering exist, the dynamic processing of data involves applying algorithms designed for the direct treatment of spatial data, and the approach based on the spatial data pre-processing, which consists of applying clustering algorithms classic pre-processed data (by integration of spatial relationships). This approach (based on pre-treatment) is quite complex in different cases, so the search for approximate solutions involves the use of approximation algorithms, including the algorithms we are interested in dedicated approaches (clustering methods for partitioning and methods for density) and approaching bees (biomimetic approach), our study is proposed to design very significant to this problem, using different algorithms for automatically detecting geo-spatial neighborhood in order to implement the method of geo- clustering by pre-treatment, and the application of the bees algorithm to this problem for the first time in the field of geo-spatial.

Keywords: mining, GIS, geo-clustering, neighborhood

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Authors: Keivan Amirbagheri, Ana Nuñez-Carballosa, Laura Guitart-Tarrés

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Over the last couple of decades, enterprises have begun to accept the need for environmental management and have started to implement environmental management programs to compete in the markets. The implementation of green supply chain management (GSCM) practices can provide valuable opportunities to improve firm performance. Through the prior investigations, the ascending tendency of the numbers of published papers in the field of green supply chain management practices has been reported and it shows the high interest level of the authors to work in this area. Besides, there is still a gap to study more about the relationship of GSCM to the organizational performance (OP). So, the purpose of this research is to study the practices related to green supply chain management that influence the results of the company as an organizational performance. Based on our previous works, from one part we have collected these GSCM practices (planning, operational, and communication practices) and classified them through conducting some literature reviews to analyze their effects on the OP’s factors (balanced scorecard’s perspectives). To do so we design a case study methodology through semi-structured interviews and secondary data from some multinational well-known companies based in Spain. The cases have been selected with the criterion of trying to collect members of the entire supply chain to have a vision as global as possible. The results report the considerable influence of green supply chain management practices on the organizational performance of the companies of the study. In addition, they represent that the implementation of green supply chain management practices especially in a long-term perspective can be economically justified. From the point of view of the personal, they feel better about being a member of this type of company that has been structured on environmental issues. Also, for these companies, the image that has been created by the implementation of these practices helps them to facilitate their marketing program.

Keywords: green supply chain management, organizational performance, case study, Spain

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Authors: Izabel Cristina Zattar, Gilberto Passos Lima, Guilherme Schünemann de Oliveira

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In Brazil, there are several institutions committed to the development of new businesses based on product innovation. Among them are business incubators, universities and science institutes. Business incubators can be defined as nurseries for new companies, which may be in the technology segment, discussed in this article. Business incubators provide services related to infrastructure, such as physical space and meeting rooms. Besides these services, incubators also offer assistance in the form of information and communication, access to finance, relationship networks and business monitoring and mentoring processes. Business incubators support not all technology companies. One of the business incubators tasks is to assess the nature and feasibility of new business proposals. To assist this goal, this paper proposes a methodology for evaluating new business using the Analytic Hierarchy Process (AHP). This paper presents the concepts used in the assessing methodology application for new business, concepts that have been tested with positive results in practice. This study counts on three main steps: first, a hierarchy was built, based on new business manuals used by the business incubators. These books and manuals relate business selection requirements, such as the innovation status and other technological aspects. Then, a questionnaire was generated, in order to guide incubator experts in the parity comparisons at all hierarchy levels. The weights of each requirement are calculated from information obtained from the questionnaire responses. Finally, the proposed method was applied to evaluate five new business proposals, which were applying to be part of a company incubator. The main result is the classification of these new businesses, which helped the incubator experts to decide what companies were more eligible to work with. This classification may also be helpful to the decision-making process of business incubators in future selection processes.

Keywords: Analytic Hierarchy Process (AHP), Brazilian companies incubators, technology companies, incubator

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Authors: Claudia Pimentel, Nuno Resende, Maria Fatima Lambert

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In the present time, catastrophe seems to be inevitable, and individuals are permanently overwhelmed with challenges that test one’s ability to cope with reality. Undoubtedly, photography surpassed the barrier of efficient communication in a world filled with omnifarious narratives. It wandered an outing shorter than words and younger than other sciences but became, nowadays, imperative in the context of several fields of knowledge, namely Heritage studies. Heritage and photography thus emerge as unapologetically related concepts, a fact that makes them equally relevant in today's society. Political, economic, social and humanitarian challenges alter the way in which the relationship with the past is managed and the way in which identities and ideas for the future are constructed. Ruins and destruction have become part of aesthetics discourse since the 18th century and are an area of interest when we discuss cultural heritage preservation. The image proves to be a unique way of revealing the event details when we refer to a catastrophic situation, whether it be anthropic, social or climatic. Like poetry, which has a challenging connection with silence, image is capable of creating spaces of sound and silence, and it is often these “pseudo-voids” that capture the attention of the spectator, of the one who sees/observes/contacts with the photography. The way we look at the catastrophe, how we describe it, and the images we keep in our memory will determine the record/capture/news of the event. We, thus, have a visual record, a document that will contribute to the creation of individual and collective identity, in a jigsaw puzzle of memories, pseudo memories and post memories. Based on photographic records in the Portuguese press, we intend to rethink the earthquake at Angra do Heroísmo – Azores in 1980, exploring the viewer´s perspective on the catastrophe’s iconography under the perspective of aesthetics and genealogy of the catastrophe.

Keywords: photography, aesthetics, catastrophe, Portugal

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Authors: Meng-Na Dai, Bao-Fang Wen, Gao-Pei Zhu, Chen-Xi Zhang, Jing Sun, Chang-Hai Tang, Zhi-Qiang Feng, Wen-Qiang Yin

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Based on the analysis of literature in the health emergency management in China with recent 10 years, this paper discusses the Chinese current research hotspots, development trends and shortcomings in this field, and provides references for scholars to conduct follow-up research. CNKI(China National Knowledge Infrastructure), Weipu, and Wanfang were the databases of this literature. The key words during the database search were health, emergency, and management with the time from 2009 to 2018. The duplicate, non-academic, and unrelated documents were excluded. 901 articles were included in the literature review database. The main indicators of abstraction were, the number of articles published every year, authors, institutions, periodicals, etc. There are some research findings through the analysis of the literature. Overall, the number of literature in the health emergency management in China has shown a fluctuating downward trend in recent 10 years. Specifically, there is a lack of close cooperation between authors, which has not constituted the core team among them yet. Meanwhile, in this field, the number of high-level periodicals and quality literature is scarce. In addition, there are a lot of research hotspots, such as emergency management system, mechanism research, capacity evaluation index system research, plans and capacity-building research, etc. In the future, we should increase the scientific research funding of the health emergency management, encourage collaborative innovation among authors in multi-disciplinary fields, and create high-quality and high-impact journals in this field. The states should encourage scholars in this field to carry out more academic cooperation and communication with the whole world and improve the research in breadth and depth. Generally speaking, the research in health emergency management in China is still insufficient and needs to be improved.

Keywords: health emergency management, research situation, bibliometrics, literature

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Authors: Ahmed Ismail, Mustafa Baysal

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Although the energy source in the world is mainly based on fossil fuels today, there is a need for alternative energy generation systems, which are more economic and environmentally friendly, due to continuously increasing demand of electric energy and lacking power resources and networks. Distributed Energy Resources (DERs) such as fuel cells, wind and solar power have recently become widespread as alternative generation. In order to solve several problems that might be encountered when integrating DERs to power system, the microgrid concept has been proposed. A microgrid can operate both grid connected and island mode to benefit both utility and customers. For most distributed energy resources (DER) which are connected in parallel in LV-grid like micro-turbines, wind plants, fuel cells and PV cells electrical power is generated as a direct current (DC) and converted to an alternative currents (AC) by inverters. So the inverters are assumed to be primary components in a microgrid. There are many control techniques of parallel inverters to manage active and reactive sharing of the loads. Some of them are based on droop method. In literature, the studies are usually focused on improving the transient performance of inverters. In this study, the performance of two different controllers based on droop control method is compared for the inverters operated in parallel without any communication feedback. For this aim, a microgrid in which inverters are controlled by conventional droop controller and modified droop controller is designed. Modified controller is obtained by adding PID into conventional droop control. Active and reactive power sharing performance, voltage and frequency responses of those control methods are measured in several operational cases. Study cases have been simulated by MATLAB-SIMULINK.

Keywords: active and reactive power sharing, distributed generation, droop control, microgrid

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Authors: Nilda San Miguel, Elymar Pascual

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The main focus of this study is exploring the effective approaches in teaching Mathematics that is being applied in public schools, s.y. 2018-2019. This research was written as connected output to the district-wide School Learning Action Cell (DISLAC) on Math teaching approaches which was recently conducted in Victoria, Laguna. Fifty-four math teachers coming from 17 schools in Victoria became the respondents of this study. Qualitative method of doing research was applied. Teachers’ responses to the following concerns were gathered, analyzed and interpreted: (1) evaluation of the recently conducted DISLAC, (2) status of the use of different approaches, (3) perception on the effective use of approaches, (4) preference of approach to explore in classroom sessions, (5) factors affecting the choice of approach, (6) difficulties encountered, (7) and perceived benefit to learners. Results showed that the conduct of DISLAC was very highly satisfactory (mean 4.41). Teachers looked at collaborative approach as very highly effective (mean 4.74). Fifty-two percent of the teachers is using collaborative approach, 17% constructivist, 11% integrative, 11% inquiry-based, and 9% reflective. Reflective approach was chosen to be explored by most of the respondents (29%) in future sessions. The difficulties encountered by teachers in using the different approaches are: (1) learners’ difficulty in following instructions, (2) lack of focus, (3) lack of willingness and cooperation, (4) teachers’ lack of mastery in using different approaches, and (5) lack of time of doing visual aids because of time mismanagement. Teachers deemed the use of various teaching approaches can help the learners to have (1) mastery of competency, (2) increased communication, (3) improved confidence, (4) facility in comprehension, and (5) better academic output. The result obtained from this study can be used as an input for SLACs. Recommendations at the end of the study were given to school/district heads and future researchers.

Keywords: approaches, collaborative, constructivism, inquiry-based, integrative, reflective

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Authors: Kaiwen Zheng, Wanting Zhou, Nan Tang, Lei Li, Yuanhang He

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The integrated circuit industry has become a cornerstone of the information society, finding widespread application in areas such as industry, communication, medicine, and aerospace. However, with the increasing complexity of integrated circuits, Hardware Trojans (HTs) implanted by attackers have become a significant threat to their security. In this paper, we proposed a hardware trojan detection method for large-scale circuits. As HTs introduce physical characteristic changes such as structure, area, and power consumption as additional redundant circuits, we proposed a machine-learning-based hardware trojan detection method based on the physical characteristics of gate-level netlists. This method transforms the hardware trojan detection problem into a machine-learning binary classification problem based on physical characteristics, greatly improving detection speed. To address the problem of imbalanced data, where the number of pure circuit samples is far less than that of HTs circuit samples, we used the SMOTETomek algorithm to expand the dataset and further improve the performance of the classifier. We used three machine learning algorithms, K-Nearest Neighbors, Random Forest, and Support Vector Machine, to train and validate benchmark circuits on Trust-Hub, and all achieved good results. In our case studies based on AES encryption circuits provided by trust-hub, the test results showed the effectiveness of the proposed method. To further validate the method’s effectiveness for detecting variant HTs, we designed variant HTs using open-source HTs. The proposed method can guarantee robust detection accuracy in the millisecond level detection time for IC, and FPGA design flows and has good detection performance for library variant HTs.

Keywords: hardware trojans, physical properties, machine learning, hardware security

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Authors: Isabell Koinig, Sandra Diehl

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In recent years, the health-care context has not been left unaffected by technological developments. In recent years, the Internet of Medical Things (IoMT)has not only led to a collaboration between disease management and advanced care coordination but also to more personalized health care and patient empowerment. With more than 40 % of all health technology being IoMT-related by 2020, questions regarding privacy become more prevalent, even more so during COVID-19when apps allowing for an intensive tracking of people’s whereabouts and their personal contacts cause privacy advocates to protest and revolt. There is a widespread tendency that even though users may express concerns and fears about their privacy, they behave in a manner that appears to contradict their statements by disclosing personal data. In literature, this phenomenon is discussed as a privacy paradox. While there are some studies investigating the privacy paradox in general, there is only scarce research related to the privacy paradox in the health sector and, to the authors’ knowledge, no empirical study investigating young people’s attitudes toward data security when using wearables and health apps. The empirical study presented in this paper tries to reduce this research gap by focusing on the area of digital and mobile health. It sets out to investigate the degree of importance individuals attribute to protecting their privacy and individual privacy protection strategies. Moreover, the question to which degree individuals between the ages of 20 and 30 years are willing to grant commercial parties access to their private data to use digital health services and apps are put to the test. To answer this research question, results from 6 focus groups with 40 participants will be presented. The focus was put on this age segment that has grown up in a digitally immersed environment. Moreover, it is particularly the young generation who is not only interested in health and fitness but also already uses health-supporting apps or gadgets. Approximately one-third of the study participants were students. Subjects were recruited in August and September 2019 by two trained researchers via email and were offered an incentive for their participation. Overall, results indicate that the young generation is well informed about the growing data collection and is quite critical of it; moreover, they possess knowledge of the potential side effects associated with this data collection. Most respondents indicated to cautiously handle their data and consider privacy as highly relevant, utilizing a number of protective strategies to ensure the confidentiality of their information. Their willingness to share information in exchange for services was only moderately pronounced, particularly in the health context, since health data was seen as valuable and sensitive. The majority of respondents indicated to rather miss out on using digital and mobile health offerings in order to maintain their privacy. While this behavior might be an unintended consequence, it is an important piece of information for app developers and medical providers, who have to find a way to find a user base for their products against the background of rising user privacy concerns.

Keywords: digital health, privacy, privacy paradox, IoMT

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Authors: Brian Kwok

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Hong Kong is well-known for its name as "the Pearl of the Orient", due to its spectacular night-view with vast amount of decorative neon lights on the streets. Neon signs are first used as the pervasive media of communication for all kinds of commercial advertising, ranging from movie theatres to nightclubs and department stores, and later appropriated by artists as medium of artwork. As a well-established visual language, it displays texts in bilingual format due to British's colonial influence, which are sometimes arranged in an opposite reading order. Research on neon signs as a visual representation is rare but significant because they are part of people’s collective memories of the unique cityscapes which associate the shifting values of people's daily lives and culture identity. Nevertheless, with the current policy to remove abandoned neon signs, their total number dramatically declines recently. The Buildings Department found an estimation of 120,000 unauthorized signboards (including neon signs) in Hong Kong in 2013, and the removal of such is at a rate of estimated 1,600 per year since 2006. In other words, the vernacular cultural values and historical continuity of neon signs will gradually be vanished if no immediate action is taken in documenting them for the purpose of research and cultural preservation. Therefore, the Hong Kong Neon Signs Archive project was established in June of 2015, and over 100 neon signs are photo-documented so far. By content analysis, this project will explore the two components of neon signs – the use of visual languages and vernacular tacit knowledge of neon makers. It attempts to answer these questions about Hong Kong's neon signs: 'What are the ways in which visual representations are used to produce our cityscapes and streetscapes?'; 'What are the visual languages and conventions of usage in different business types?'; 'What the intact knowledge are applied when producing these visual forms of neon signs?'

Keywords: cityscapes, neon signs, tacit knowledge, visual representation

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Authors: Haris Karnezi, Kevin Tierney

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Cognitive Behaviour Drama is a research-based intervention model that brought together the science of psychology with the art form of drama to create an unobtrusive and exciting approach that would provide children on the higher end of the autism spectrum the motivation to explore the rules of social interaction and develop competencies associated with communicative success. The method involves engaging the participants in exciting fictional scenarios and encouraging them to seek various solutions on a number of problems that will lead them to an understanding of causal relationships and how a different course of action may lead to a different outcome. The sessions are structured to offer opportunities to the participants to practice target behaviours and understand the functions they serve. The study involved six separate interventions and employed both single case and group designs. Overall 8 children aged between 6 to 13 years, diagnosed with ASD participated in the study. Outcomes were measured using theory of mind tests, executive functioning tests, behavioural observations, pre and post intervention standardised social competence questionnaires for parents and teachers. Collectively, the results indicated positive changes in the self esteem and behaviour of all eight participants. In particular, improvements in the ability to solve theory of mind tasks were noted in the younger group; and qualitative improvements in social communication, in terms of verbal (content) and non verbal expression (body posture, vocal expression, fluency, eye contact, reduction of ritualistic mannerisms) were noted in the older group. The need for reliable impact measures to assess the effectiveness of the model in generating global changes in the participants’ behaviour outside the therapeutic context was identified.

Keywords: autism, drama, intervention, social skills

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Authors: G. Iacoviello, A. Lazzini

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This paper focuses on the development of the study of accounting in the Italian education system between the 19th and 20th centuries. It also focuses on the subsequent formation of a scientific and experimental forma mentis that would prepare students for administrative and managerial activities in industry, commerce and public administration. From a political perspective, the period was characterized by two dominant movements - liberalism (1861-1922) and fascism (1922-1945) - that deeply influenced accounting practices and the entire Italian education system. The materials used in the study include both primary and secondary sources. The primary sources used to inform this study are numerous original documents issued from 1890-1935 by the government and maintained in the Historical Archive of the State in Rome. The secondary sources have supported both the development of the theoretical framework and the definition of the historical context. This paper assigns to the educational system the role of cultural producer. Foucauldian analysis identifies the problem confronted by the critical intellectual in finding a way to deploy knowledge through a 'patient labour of investigation' that highlights the contingency and fragility of the circumstances that have shaped current practices and theories. Education can be considered a powerful and political process providing students with values, ideas, and models that they will subsequently use to discipline themselves, remaining as close to them as possible. It is impossible for power to be exercised without knowledge, just as it is impossible for knowledge not to engender power. The power-knowledge relationship can be usefully employed for explaining how power operates within society, how mechanisms of power affect everyday lives. Power is employed at all levels and through many dimensions including government. Schools exercise ‘epistemological power’ – a power to extract a knowledge of individuals from individuals. Because knowledge is a key element in the operation of power, the procedures applied to the formation and accumulation of knowledge cannot be considered neutral instruments for the presentation of the real. Consequently, the same institutions that produce and spread knowledge can be considered part of the ‘power-knowledge’ interrelation. Individuals have become both objects and subject in the development of knowledge. If education plays a fundamental role in shaping all aspects of communities in the same way, the structural changes resulting from economic, social and cultural development affect the educational systems. Analogously, the important changes related to social and economic development required legislative intervention to regulate the functioning of different areas in society. Knowledge can become a means of social control used by the government to manage populations. It can be argued that the evolution of Italy’s education systems is coherent with the idea that power and knowledge do not exist independently but instead are coterminous. This research aims to reduce such a gap by analysing the role of the state in the development of accounting education in Italy.

Keywords: education system, government, knowledge, power

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Authors: Hamed Delrobai Ghoochan Atigh

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Androgenic alopecia (AGA) is a common form of hair loss, impacting approximately 50% of females, which leads to reduced self-esteem and quality of life. It causes progressive follicular miniaturization in genetically predisposed individuals. Mesotherapy -- a minimally invasive procedure, topical 2% minoxidil, and oral finasteride have emerged as popular treatment options in the realm of cosmetics. However, the efficacy of mesotherapy compared to other options remains unclear. This study aims to assess the effectiveness of mesotherapy when it is added to topical 2% minoxidil treatment on female androgenic alopecia. Mesotherapy, also known as intradermotherapy, is a technique that entails administering multiple intradermal injections of a carefully composed mixture of compounds in low doses, applied at various points in close proximity to or directly over the affected areas. This study involves a randomized controlled trial with 100 female participants diagnosed with androgenic alopecia. The subjects were randomly assigned to two groups: Group A used topical 2% minoxidil twice daily and took Finastride oral tablet. For Group B, 10 mesotherapy sessions were added to the prior treatment. The injections were administered every week in the first month of treatment, every two weeks in the second month, and after that the injections were applied monthly for four consecutive months. The response assessment was made at baseline, the 4th session, and finally after 6 months when the treatment was complete. Clinical photographs, 7-point Likert scale patient self-evaluation, and 7-point Likert scale assessment tool were used to measure the effectiveness of the treatment. During this evaluation, a significant and visible improvement in hair density and thickness was observed. The study demonstrated a significant increase in treatment efficacy in Group B compared to Group A post-treatment, with no adverse effects. Based on the findings, it appears that mesotherapy offers a significant improvement in female AGA over minoxidil. Hair loss was stopped in Group B after one month and improvement in density and thickness of hair was observed after the third month. The findings from this study provide valuable insights into the efficacy of mesotherapy in treating female androgenic alopecia. Our evaluation offers a detailed assessment of hair growth parameters, enabling a better understanding of the treatments' effectiveness. The potential of this promising technique is significantly enhanced when carried out in a medical facility, guided by appropriate indications and skillful execution. An interesting observation in our study is that in areas where the hair had turned grey, the newly regrown hair does not retain its original grey color; instead, it becomes darker. The results contribute to evidence-based decision-making in dermatological practice and offer different insights into the treatment of female pattern hair loss.

Keywords: androgenic alopecia, female hair loss, mesotherapy, topical 2% minoxidil

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