Search results for: patient knowledge

Authors: Imen Ben Abda

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Languages have been classified into different rhythm classes. 'Stress-timed' languages are exemplified by English, 'syllable-timed' languages by French and 'mora-timed' languages by Japanese. However, to our best knowledge, acoustic studies have not been unanimous in strictly establishing which rhythm category a given language belongs to and failed to show empirical evidence for isochrony. Perception seems to be a good approach to categorize languages into different rhythm classes. This study, within the scope of experimental phonetics, includes an account of different perceptual experiments using cues from natural and inverted speech, as well as pitch extracted from speech data. It is an attempt to categorize speech rhythm over a large set of Arabic (Tunisian, Algerian, Lebanese and Moroccan) and English dialects (Welsh, Irish, Scottish and Texan) as well as other languages such as Chinese, Japanese, French, and German. Listeners managed to classify the different languages and dialects into different rhythm classes using suprasegmental cues mainly rhythm and pitch (F0). They also perceived rhythmic differences even among languages and dialects belonging to the same rhythm class. This may show that there are different subclasses within very broad rhythmic typologies.

Keywords: F0, inverted speech, mora-timing, rhythm variation, stress-timing, syllable-timing

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Authors: Ahmed Sami Hammami, Mohamed Jellazi

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Background: The aim of the study is to evaluate the magnitude of different psychological outcomes among Tunisian health care professionals (HCP) during the COVID-19 pandemic and to identify the associated factors. Methods: HCP completed a cross-sectional questionnaire from April 4th to April, 28th 2020. The survey collected demographic information, factors that may interfere with the psychological outcomes, behavior changes and mental health measurements. The latter was assessed through 3 scales; the 7-item questions Insomnia Severity Index, the 2-item Patient Health Questionnaire and the 2-item Generalized Anxiety Disorder. Multivariable logistic regression was conducted to identify factors associated with psychological outcomes. Results: A total of 503 HCP successfully completed the survey; among those, n=493 consented to enroll in the study, 411 [83.4%] were physicians, 323 [64.2%] were women and 271 [55%] had a second-line working position. A significant proportion of HCP had anxiety 35.7%, depression 35.1% and insomnia 23.7%. Females, those with psychiatric history and those using public transport exhibited the highest proportions for overall symptoms compared to other groups e.g., depression among females vs. males: 44,9% vs. 18,2%, P=0.00. Those with a previous medical history and nurses, had more anxiety and insomnia compared to other groups e.g. anxiety among nurses vs. interns/residents vs. attending 45,1% vs 36,1% vs 27,5%; p=0.04. Multivariable logistic regression showed that female gender was a risk factor for all psychological outcomes e.g. female sex increased the odds of anxiety by 2.86; 95% confidence interval [CI], 1, 78-4, 60; P=0.00, whereas having a psychiatric history was a risk factor for both anxiety and insomnia. (e.g. for insomnia OR=2,86; 95% [CI], 1,78-4,60; P=0.00), Having protective equipment was associated with lower risk for depression (OR=0,41; 95% CI, 0,27-0,62; P=0.00) and anxiety. Physical activity was also protective against depression and anxiety (OR=0,41, 95% CI, 0,25-0,67, P=0.00). Conclusion: Psychological symptoms are usually undervalued among HCP, though the COVID-19 pandemic played a major role in exacerbating this burden. Prompt psychological support should be endorsed and simple measures such as physical activity and ensuring the necessary protection are paramount to improve mental health outcomes and the quality of care provided to patients.

Keywords: COVID-19 pandemic, health care professionals, mental health, protective factors, psychological symptoms, risk factors

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Authors: Shende Suraj Balu, A. B. Deoghare, K. M. Pandey

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The human middle ear (ME) is a delicate and vital organ. It has a complex structure that performs various functions such as receiving sound pressure and producing vibrations of eardrum and propagating it to inner ear. It consists of Tympanic Membrane (TM), three auditory ossicles, various ligament structures and muscles. Incidents such as traumata, infections, ossification of ossicular structures and other pathologies may damage the ME organs. The conditions can be surgically treated by employing prosthesis. However, the suitability of the prosthesis needs to be examined in advance prior to the surgery. Few decades ago, this issue was addressed and analyzed by developing an equivalent representation either in the form of spring mass system, electrical system using R-L-C circuit or developing an approximated CAD model. But, nowadays a three-dimensional ME model can be constructed using micro X-Ray Computed Tomography (μCT) scan data. Moreover, the concern about patient specific integrity pertaining to the disease can be examined well in advance. The current research work emphasizes to develop the ME model from the stacks of μCT images which are used as input file to MIMICS Research 19.0 (Materialise Interactive Medical Image Control System) software. A stack of CT images is converted into geometrical surface model to build accurate morphology of ME. The work is further extended to understand the dynamic behaviour of Harmonic response of the stapes footplate and umbo for different sound pressure levels applied at lateral side of eardrum using finite element approach. The pathological condition Cholesteatoma of ME is investigated to obtain peak to peak displacement of stapes footplate and umbo. Apart from this condition, other pathologies, mainly, changes in the stiffness of stapedial ligament, TM thickness and ossicular chain separation and fixation are also explored. The developed model of ME for pathologies is validated by comparing the results available in the literatures and also with the results of a normal ME to calculate the percentage loss in hearing capability.

Keywords: computed tomography (μCT), human middle ear (ME), harmonic response, pathologies, tympanic membrane (TM)

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Authors: Florence Awde

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In 2023, it was expected 350 parents in Arizona would have a child receive a cancer diagnosis (Welcome Arizona Cancer Foundation For Children, n.d.). The news of a child’s diagnosis with cancer can be overwhelming and confusing, especially for those lucky enough to lack a personal tie to the disease that takes approximately 1800 children’s lives each year in the United States (Deegan et al., n.d.). A parent’s beliefs, attitudes, and understandings surrounding cancer are vital for medical staff to provide adequate and culturally competent care for each patient, especially across cultural and ethnic lines in regions housing multicultural populations. Arizona's cultural/linguistic mosaic houses many White and Latino populations and English and Spanish speakers. Variations in insurance coverage, from those insured through public insurance programs (e.g., Medicaid) or private insurance plans (e.g., employee-sponsored insurance) versus those uninsured, also factor into health-seeking attitudes and behaviors. To further understand parental attitudes, understandings, and beliefs towards childhood cancer, 22 parents (11 of Latino ethnicity, 11 of White ethnicity) were interviewed on these facets of childhood cancer, despite 21 of the 22 never having a child receive a cancer diagnosis. The exploration of these perceptions across ethnic lines revealed a higher report of fear-orientated beliefs amongst Latino parents--hypothesized to be rooted in the starkly contrasting lack of belief in the possibility of recovering for children with cancer, compared to their white counterparts who displayed more optimism in the recovery process. Further, this study’s results lay the foundation for future scholarship to explore avenues of information dispersal to Latino parents that correct misconceptions of health outcomes and enable earlier intervention to be possible, ultimately correlating to better health and treatment outcomes by increasing parental health literacy rates for childhood cancer in the Phoenix Metropolitan.

Keywords: Childhood Cancer, Parental Beliefs, Parental Attitudes, Parental Understandings, Phoenix Metropolitan, Culturally Competent Care, Health Disparities, Health Inequities

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Authors: Sara Fallahi

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This paper reviews the importance of content familiarity of receptive skills and offers solutions to the issue of content unfamiliarity in language learning materials. Presently, language learning materials are mainly comprised of global issues and target language speakers’ culture(s) in receptive skills. This might leadlearners to focus on content rather than the language. As a solution, materials on receptive skills can be developed with a focus on learners’culture and social concerns, especially in the beginner levels of learning. Language learners often learn their target language through the receptive skills of listening and reading before language production ensues through speaking and writing. Students’ journey from receptive skills to productive skills is mainly concentrated on by teachers. There are barriers to language learning, such as time and energy, that can hinder learners’ understanding and ability to build the required background knowledge of the content. This is generated due to learners’ unfamiliarity with the skill’s content. Therefore, materials that improve content familiarity will help learners improve their language comprehension, learning, and usage. This presentation will conclude with practical solutions to help teachers and learners more authentically integrate language and culture to elevate language learning.

Keywords: language learning, listening content, reading content, content familiarity, ESL books, language learning books, cultural familiarity

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Authors: Oluwasina Folajinmi, Kate Ssamulla, Penninah Lutung, Daniel Reijer

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Background: Despite of well-verified benefits of anti-retroviral therapy (ART) in prolonging life expectancy being lost to follow-up (LTFU) presents a challenge to the success of ART programs in resource limited countries like Nigeria. In several studies of ART programs in developing countries, researchers have reported that there has been a high rate of LTFU among patients receiving care and treatment at ART treatment centers. This study seeks to determine the cause of LTFU among HIV clients. Method: A descriptive cross sectional study focused on a population of 9,280 persons living with HIV/AIDS who were enrolled in nine treatment centers in Nigeria (both pre-ART and ART patients were included). Out of the total population, 1752 (18.9%) were found to be LTFU. Of this group we randomly selected 1200 clients (68.5%) their d patients’ information was generated through a database. Data on demographics and CD4 counts, causes of LTFU were analyzed and summarized. Results: Out of 1200 LTFU clients selected, 462 (38.5%) were on ART; 341 clients (73.8%) had CD4 level < 500cell/µL and 738 (61.5%) on pre-ART had CD4 level >500/µL. In our records we found telephone number for 675 (56.1%) of these clients. 675 (56.1%) were owners of a phone. The majority of the client’s 731 (60.9%) were living at not more than 25km away from the ART center. A majority were females (926 or 77.2%) while 274 (22.8%) were male. 675 (56.1%) clients were reported traced via telephone and home address. 326 (27.2%) of clients phone numbers were not reachable; 173 (14.4%) of telephone numbers were incomplete. 71 (5.9%) had relocated due to communal crises and expert client trackers reported that some patient could not afford transportation to ART centers. Conclusion: This study shows that, low health education levels, poverty, relocations and lack of reliable phone contact were major predictors of LTFU. Periodic updates of home addresses, telephone contacts including at least two next of kin, phone text messages and home visits may improve follow up. Early and consistent tracking of missed appointments is crucial. Creation of more ART decentralized centres are needed to avoid long distances.

Keywords: anti-retroviral therapy, HIV/AIDS, predictors, lost to follow up

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Authors: David Mafullul, Jiang Lei, Edward Goacher, Jibin Francis

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PURPOSE: Timely decompressive surgery for cauda equina syndrome (CES) is dependent on efficient referral pathways for patients presenting at local primary or secondary centres to tertiary spinal centres in the United Kingdom (UK). Identifying modifiable points of delay within this process is important as minimising time between presentation and surgery may improve patient outcomes. This study aims to analyse whether adequacy of referral impacts on time to surgery in CES. MATERIALS AND METHODS: Data from all cases of confirmed CES referred to a single tertiary UK hospital between August 2017 to December 2019, via a suspected CES e-referral pathway, were obtained retrospectively. Referral adequacy was defined by the inclusion of sufficient information to determine the presence or absence of several NICE ‘red flags’. Correlation between referral adequacy and delay from referral-to-surgery was then analysed. RESULTS: In total, 118 confirmed CES cases were included. Adequate documentation for saddle anaesthesia was associated with reduced delays of more than 48 hours from referral-to-surgery [X2(1, N=116)=7.12, p=.024], an effect partly attributable to these referrals being accepted sooner [U=16.5; n1=27, n2=4, p=.029, r=.39]. Other red flags had poor association with delay. Referral adequacy was better for somatic red flags [bilateral sciatica (97.5%); severe or progressive bilateral neurological deficit of the legs (95.8%); saddle anaesthesia (91.5%)] compared to autonomic red flags [loss of anal tone (80.5%); urinary retention (79.7%); faecal incontinence or lost sensation of rectal fullness (57.6%)]. Although referral adequacy for urinary retention was 79.7%, only 47.5% of referrals documented a post-void residual numerical value. CONCLUSIONS: Adequate documentation of saddle anaesthesia in e-referrals is associated with reduced delay-to-surgery for confirmed CES, partly attributable to these referrals being accepted sooner. Other red flags had poor association with delay to surgery. Referral adequacy for autonomic red flags, including documentation for post-void residuals, has significant room for improvement.

Keywords: cauda equina, cauda equina syndrome, neurosurgery, spinal surgery, decompression, delay, referral, referral adequacy

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Authors: Angel Daniel Muñoz Guzmán

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E-learning is becoming more and more common every day. For online, hybrid or traditional face-to-face programs, there are some e-teaching platforms like Google classroom, Blackboard, Moodle and Canvas, and there are platforms for full e-learning like Coursera, edX or Udemy. These tools are changing the way students acquire knowledge at schools; however, in today’s changing world that is not enough. As students’ needs and skills change and become more complex, new tools will need to be added to keep them engaged and potentialize their learning. This is especially important in the current global situation that is changing everything: the Covid-19 pandemic. Due to Covid-19, education had to make an unexpected switch from face-to-face courses to digital courses. In this study, the students’ learning experience is analyzed by applying different e-tools and following the Tec21 Model and a flexible and digital model, both developed by the Tecnologico de Monterrey University. The evaluation of the students’ learning experience has been made by the quantitative PrEmo method of emotions. Findings suggest that the quantity of e-tools used during a course does not affect the students’ learning experience as much as how a teacher links every available tool and makes them work as one in order to keep the student engaged and motivated.

Keywords: student, experience, e-learning, e-teaching, e-tools, technology, education

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Authors: Yolina A. Petrova, Georgi I. Petkov

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The paper presents a symbolic model for category learning and categorization (called RoleMap). Unlike the other models which implement learning in a separate working mode, role-governed category learning and categorization emerge in RoleMap while it does its usual reasoning. The model is based on several basic mechanisms known as reflecting the sub-processes of analogy-making. It steps on the assumption that in their everyday life people constantly compare what they experience and what they know. Various commonalities between the incoming information (current experience) and the stored one (long-term memory) emerge from those comparisons. Some of those commonalities are considered to be highly important, and they are transformed into concepts for further use. This process denotes the category learning. When there is missing knowledge in the incoming information (i.e. the perceived object is still not recognized), the model makes anticipations about what is missing, based on the similar episodes from its long-term memory. Various such anticipations may emerge for different reasons. However, with time only one of them wins and is transformed into a category member. This process denotes the act of categorization.

Keywords: analogy-making, categorization, category learning, cognitive modeling, role-governed categories

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Authors: Wisam Ismail, Sarah Hosgood, Michael Nicholson

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The research hypothesis is that early post-transplant allograft fibrosis will be linked to donor factors and that acute rejection and/or delayed graft function in the recipient will be independent risk factors for the development of fibrosis. This research hypothesis is to explore whether acute rejection/delay graft function has an effect on the renal transplant fibrosis within the first year post live donor kidney transplant between 1998 and 2009. Methods: The study has been designed to identify five time points of the renal transplant biopsies [0 (pre-transplant), 1 month, 3 months, 6 months and 12 months] for 300 live donor renal transplant patients over 12 years period between March 1997 – August 2009. Paraffin fixed slides were collected from Leicester General Hospital and Leicester Royal Infirmary. These were routinely sectioned at a thickness of 4 Micro millimetres for standardization. Conclusions: Fibrosis at 1 month after the transplant was found significantly associated with baseline fibrosis (p<0.001) and HTN in the transplant recipient (p<0.001). Dialysis after the transplant showed a weak association with fibrosis at 1 month (p=0.07). The negative coefficient for HTN (-0.05) suggests a reduction in fibrosis in the absence of HTN. Fibrosis at 1 month was significantly associated with fibrosis at baseline (p 0.01 and 95%CI 0.11 to 0.67). Fibrosis at 3, 6 or 12 months was not found to be associated with fibrosis at baseline (p=0.70. 0.65 and 0.50 respectively). The amount of fibrosis at 1 month is significantly associated with graft survival (p=0.01 and 95%CI 0.02 to 0.14). Rejection and severity of rejection were not found to be associated with fibrosis at 1 month. The amount of fibrosis at 1 month was significantly associated with graft survival (p=0.02) after adjusting for baseline fibrosis (p=0.01). Both baseline fibrosis and graft survival were significant predictive factors. The amount of fibrosis at 1 month was not found to be significantly associated with rejection (p=0.64) after adjusting for baseline fibrosis (p=0.01). The amount of fibrosis at 1 month was not found to be significantly associated with rejection severity (p=0.29) after adjusting for baseline fibrosis (p=0.04). Fibrosis at baseline and HTN in the recipient were found to be predictive factors of fibrosis at 1 month. (p 0.02, p <0.001 respectively). Age of the donor, their relation to the patient, the pre-op Creatinine, artery, kidney weight and warm time were not found to be significantly associated with fibrosis at 1 month. In this complex model baseline fibrosis, HTN in the recipient and cold time were found to be predictive factors of fibrosis at 1 month (p=0.01,<0.001 and 0.03 respectively). Donor age was found to be a predictive factor of fibrosis at 6 months. The above analysis was repeated for 3, 6 and 12 months. No associations were detected between fibrosis and any of the explanatory variables with the exception of the donor age which was found to be a predictive factor of fibrosis at 6 months.

Keywords: fibrosis, transplant, renal, rejection

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Authors: Mouheb Mehdoui, Amel Fraisse, Mounir Zrigui

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This paper explores the potential of short texts through semantic enrichment and disambiguation techniques. By employing context fusion, we aim to enhance the comprehension and utility of concise textual information. The methodologies utilized are grounded in recent advancements in natural language processing, which allow for a deeper understanding of semantics within limited text formats. Specifically, topic classification is employed to understand the context of the sentence and assess the relevance of added expressions. Additionally, word sense disambiguation is used to clarify unclear words, replacing them with more precise terms. The implications of this research extend to various applications, including information retrieval and knowledge representation. Ultimately, this work highlights the importance of refining short text processing techniques to unlock their full potential in real-world applications.

Keywords: information traffic, text summarization, word-sense disambiguation, semantic enrichment, ambiguity resolution, short text enhancement, information retrieval, contextual understanding, natural language processing, ambiguity

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Authors: Carles Martinez-Almoyna Gual, Jiwon Choi

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Urban communities face risks of disintegration and segregation as a consequence of globalised migration processes towards urban environments. Linking social and cultural components with environmental and economic dimensions becomes the goal of all the disciplines that aim to shape more sustainable urban environments. Solutions require interdisciplinary approaches and the use of a complex array of tools. One of these tools is the implementation of urban farming, which provides a wide range of advantages for creating more inclusive spaces and integrated communities. Since food is strongly related to the values and identities of any cultural group, it can be used as a medium to promote social inclusion in the context of urban multicultural societies. By bringing people together into specific urban sites, food production can be integrated into multifunctional spaces while addressing social, economic and ecological goals. The goal of this research is to assess different approaches to urban agriculture by analysing three existing community gardens located in Newtown, a suburb of Wellington, New Zealand. As a context for developing research, Newtown offers different approaches to urban farming and is really valuable for observing current trends of socialization in diverse and multicultural societies. All three spaces are located on public land owned by Wellington City Council and confined to a small, complex and progressively denser urban area. The developed analysis was focused on social, cultural and physical dimensions, combining community engagement with different techniques of spatial assessment. At the same time, a detailed investigation of each community garden was conducted with comparative analysis methodologies. This multidirectional setting of the analysis was established for extracting from the case studies both specific and typological knowledge. Each site was analysed and categorised under three broad themes: people, space and food. The analysis revealed that all three case studies had really different spatial settings, different approaches to food production and varying profiles of supportive communities. The main differences identified were demographics, values, objectives, internal organization, appropriation, and perception of the space. The community gardens were approached as case studies for developing design research. Following participatory design processes with the different communities, the knowledge gained from the analysis was used for proposing changes in the physical environment. The end goal of the design research was to improve the capacity of the spaces to facilitate social inclusiveness. In order to generate tangible changes, a range of small, strategic and feasible spatial interventions was explored. The smallness of the proposed interventions facilitates implementation by reducing time frames, technical resources, funding needs, and legal processes, working within the community´s own realm. These small interventions are expected to be implemented over time as part of an ongoing collaboration between the different communities, the university, and the local council. The applied research methodology showcases the capacity of universities to develop civic engagement by working with real communities that have concrete needs and face overall threats of disintegration and segregation.

Keywords: community gardening, landscape architecture, participatory design, placemaking, social inclusion

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Authors: Hsin-Hsin Chang, Jann-Tay Wang, Wang-Huei Sheng

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Background: Hospital-associated infections (HAIs) have significant medical and social resource consumption. In view of medical technology change rapidly and the prolonged average life expectancy, the patients' chances of receiving invasive medical devices have also increased. As well as the potential disease of the patients, the aging, and immune dysfunction makes the disease more serious, raising the risk of HAIs. In our adult intensive care units, catheter-associated urinary tract infections (CAUTIs) have an average of 4.6% in 2014, which is much higher than that of the National Healthcare Safety Network (NHSN). Therefore, we started the intervention of CAUTI bundle care. Methods: This 3-year intervention was conducted in adults’ intensive care units (ICUs) during January 2015 to December 2017. The implementation of CAUTI bundle care in order to reduce invasive catheter-associated infections were built on evidence-based infection control measures. Prospective surveillance was performed on all patients admitted to hospital. The four major directions are 'Leader Engagement', 'Educate Personnel', 'Executive Multidisciplinary Teamwork', 'Innovation and Improvement of Tools'. Results: During the intervention period, there were 167,024 patient-days with a total of 508 episodes of CAUTIs in the entire adult ICUs identified. The incidence of CAUTIs in adult ICU was significantly decreased in the intervention period (from 2015 to 2017), from 4.6 to 3.6 per 1000 catheter days (p=0.05). Conclusion: The necessity for the implementation of CAUTI bundle care in the health care system plays an important role in the quality and policy of infection control. Multidisciplinary teamwork, education, a comprehensive checklist and from time to time audit feedback to improve healthcare workers’ compliance are the keys to success.

Keywords: bundle care, hospital-associated infections, leader engagement, multidisciplinary team work

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Authors: Sitti Rahmawati

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Payment system of cataract surgery implemented by professional attendant of doctor and nurse has been increasing, through health insurance program and this has become one of the factors that affects a lot of government in the budget establishment. This system has been implemented in purpose of quality and expenditure control, i.e., controlling health overpayment to obtain benefit (moral hazard) by the user of insurance or health service provider. The increasing health cost becomes the main issue that hampers the society to receive required health service in cash payment-system. One of the efforts that should be taken by the government in health payment is by securing health insurance through society's health insurance. The objective of the study is to learn the capability of a patient to pay cataract eye operation for the elders. Method of study sample population in this study was patients who obtain health insurance board card for the society that was started in the first of tri-semester (January-March) 2015 and claimed in Indonesian software-Case Based Group as a purposive sampling of 40 patients. Results of the study show that total unit cost analysis of surgery service unit was obtained $75 for unit cost without AFC and salary of nurse and doctor. The operation tariff that has been implemented today at Anutapura hospitals in eye department is tariff without AFC and the salary of the employee is $80. The operation tariff of the unit cost calculation with double distribution model at $65. Conclusion, the calculation result of actual unit cost that is much greater causes incentive distribution system provided to an ophthalmologist at $37 and nurse at $20 for one operation. The surgery service tariff is still low; consequently, the hospital receives low revenue and the quality of health insurance in eye operation department is relatively low. In purpose of increasing the service quality, it requires adequately high cost to equip medical equipment and increase the number of professional health attendant in serving patients in cataract eye operation at hospital.

Keywords: economic evaluation, cataract operation, health attendant, health insurance system

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Authors: Girma Yohannis Bade, Olga Kolesnikova, Grigori Sidorov

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

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

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Authors: Shah Hussain Awan

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This study investigates the role of Business Incubation Centers (BICs) in fostering entrepreneurship in Pakistani universities. The high failure rate in new startups around the world has opened a challenging discussion. Though encouraging steps and strategies have been taken to overcome these challenges, still more aggressive action needs to be taken. However, Pakistan is one of the countries that promote entrepreneurship through BICs. The purpose of the present study is to develop a conceptual model that assesses the moderating impact of government policy on entrepreneurship development through business incubation centers of public and private universities. This area is under-researched, particularly in the context of Pakistan; therefore, this research may contribute to the existing body of knowledge to appraise the industry in Pakistan. The data collection procedure included a survey of stakeholders from private and public universities in Pakistan and was analyzed by SmartPLS 4.0. The findings show that Business incubation centers and government support have a significant impact on entrepreneurship development in Pakistan. Moderation analysis showed that for business incubation centers to be successful and effective, the government needs to implement efficient policies to inculcate entrepreneurship.

Keywords: business incubation centers, government support, policies, startup performance, entrepreneurship development

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Authors: Nada Bezić, Valerija Dunkić, Antonija Markovina, Mirko Rušćić

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Valeriana is a genus of the well-known medicinal plant of Valerianacea family and growing wild in the sub-Mediterranean area. This abstract reports the types and distribution of trichomes and phyto-active composition of the essential oil of the Valeriana tuberosa from mountain Kozjak, near Split, Croatia. Two types of glandular trichomes: peltate (one basal epidermal cell, one short stalk cell and a small head) and capitate trichomes (one basal epidermal cell, one elongated stalk cell) were observed on leaf, using light microscopy. We analyzed the composition of the essential oil of stems and leaves of V. tuberosa species. Water distilled essential oils from aerial parts of investigation plant have been analysed by GC and GC/MS using VF-5ms capillary column. The total yield of oil was 0.2%, based on dry weight of samples. Forty compounds representing 94.1% of the total oil of V. tuberosa. This essential oil was characterized by a high concentration of isovaleric acid (17.2%), geranyl isovalerate (12.2%) and caryophyllene oxide (7.7%). The present study gives additional knowledge about micromorphological traits and secondary metabolites contents on the genus Valeriana.

Keywords: essential oil, isovaleric acid, Valeriana tuberosa, Croatia

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Authors: Daniel Scherman, Daniel Madani, Shanu Gambhir, Marcus Ling Zhixing, Yingda Li

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Objective: This study aims to identify clinical factors that may predict failed endoscopic lumbar spine surgery to guide surgeons with patient selection during the initial learning curve. Methods: This is an Australasian prospective analysis of the first 105 patients to undergo lumbar endoscopic spine decompression by 3 surgeons. Modified MacNab outcomes, Oswestry Disability Index (ODI) and Visual Analogue Score (VAS) scores were utilized to evaluate clinical outcomes at 6 months postoperatively. Descriptive statistics and Anova t-tests were performed to measure statistically significant (p<0.05) associations between variables using GraphPad Prism v10. Results: Patients undergoing endoscopic lumbar surgery via an interlaminar or transforaminal approach have overall good/excellent modified MacNab outcomes and a significant reduction in post-operative VAS and ODI scores. Regardless of the anatomical location of disc herniations, good/excellent modified MacNab outcomes and significant reductions in VAS and ODI were reported post-operatively; however, not in patients with calcified disc herniations. Patients with central and foraminal stenosis overall reported poor/fair modified MacNab outcomes. However, there were significant reductions in VAS and ODI scores post-operatively. Patients with subarticular stenosis or an associated spondylolisthesis reported good/excellent modified MacNab outcomes and significant reductions in VAS and ODI scores post-operatively. Patients with disc herniation and concurrent degenerative stenosis had generally poor/fair modified MacNab outcomes. Conclusion: The outcomes of endoscopic spine surgery are encouraging, with a low complication and reoperation rate. However, patients with calcified disc herniations, central canal stenosis or a disc herniation with concurrent degenerative stenosis present challenges during the initial learning curve and may benefit from traditional open or other minimally invasive techniques.

Keywords: complications, lumbar disc herniation, lumbar endoscopic spine surgery, predictors of failed endoscopic spine surgery

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Authors: Veruska C. Dutra, Mary L. G. S. Senna

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The principle of sustainability has been studied by different sciences with the purpose of formulating clear and concrete models. Much has been discussed about sustainability, and several points of view have been used to try to explain it; environmental science emerges from various environmental discourses that are willing to establish a new concept for understanding this complexity. This way, we focus on the activity of ecotourism as a way to integrate sustainable practices proposed by environmental science, and thus, make it possible to create a new perspective for eco-tourists and the managers of tourist destinations towards nature. The aim of this study was to suggest a direction for environmental awareness, based on environmental science, to change the eco-tourist's view of nature in ecotourism tours. The methodology used was based on a case study concerning the Jalapão State Park - JSP, located in the State of Tocantins, Northern Brazil. The study was based on discussions, theoretical studies, bibliographical research and on-site research. We have identified that to incite the tourists’ awareness, they need to visit nature to understand the environmental problems and promote actions for its preservation. We highlight in this study actions to drive their human perception through environmental science, so that the ecotourism itinerary tours to the JSP, promote a balance between the natural environment and the tourist, making them, in this way, environmental tourists.

Keywords: science, environmental, ecoturism, Jalapão

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Authors: Saba Shams Bidhendi, Steven Goh, Andrew Wandel

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The implementation of lean manufacturing initiatives has produced significant impacts in improving operational performance and reducing manufacturing wastes in the production process. However, selecting an appropriate set of lean strategies is critical to avoid misapplication of the lean manufacturing techniques and consequential increase in non-value-adding activities. To the author’s best knowledge, there is currently no methodology to select lean strategies that considers their impacts on manufacturing wastes and performance metrics simultaneously. In this research, a multi-objective methodology is proposed that suggests an appropriate set of lean initiatives based on their impacts on performance metrics and manufacturing wastes and within manufacturers’ resource limitation. The proposed methodology in this research suggests the best set of lean initiatives for implementation that have highest impacts on identified critical performance metrics and manufacturing wastes. Therefore, manufacturers can assure that implementing suggested lean tools improves their production performance and reduces manufacturing wastes at the same time. A case study was conducted to show the effectiveness and validate the proposed model and methodologies.

Keywords: lean manufacturing, lean strategies, manufacturing wastes, manufacturing performance, optimisation, decision making

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Authors: Christina Kalogirou

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The object of this research is to explore the views of Greek Second Chance Schools’ (SCS) graduates regarding their personal, social, professional and educational development after graduation. SCS are addressed to adults who had failed to complete their studies in the nine-year compulsory education. Furthermore, the research focuses on their motives as well as on any possible achievement of transformative processes. The quantitative survey involved in total 426 graduates while in the qualitative survey participated 38 persons, all of whom graduated in the period 2010-2012 from 27 schools throughout the country. The survey was conducted by filling in a structured questionnaire and by carrying out semi-structured interviews. As regards the results, the respondents decided to attend the SCS primarily to acquire knowledge while most of them feel that they managed to meet their goals. Also, graduates recognize that studying in SCS contributed primarily in their social and personal development. In addition, an encouraging fact is that some of the graduates recognize the transformative processes which they experienced during their studies in SCS.

Keywords: Adults Education, Motives of Attendance, Personal-Social-Professional-Educational Development, Transformative Processes, Quantitative and Qualitative Survey

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Authors: June Keeling, Christina Athanasiades, Vaiva Hendrixson, Delyth Wyndham

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Recognition and education in violence, abuse, and neglect for medical and healthcare practitioners (REVAMP) is a trans-European project aiming to introduce a training programme that has been specifically developed by partners across seven European countries to meet the needs of medical and healthcare practitioners. Amalgamating the knowledge and experience of clinicians, researchers, and educators from interdisciplinary and multi-professional backgrounds, REVAMP has tackled the under-resourced and underdeveloped area of domestic violence and abuse. The team designed an online training programme to support medical and healthcare practitioners to recognise and respond appropriately to survivors of domestic violence and abuse at their point of contact with a health provider. The REVAMP partner countries include Europe: France, Lithuania, Germany, Greece, Iceland, Norway, and the UK. The training is delivered through a series of interactive online modules, adapting evidence-based pedagogical approaches to learning. Capturing and addressing the complexities of the project impacted the methodological decisions and approaches to evaluation. The challenge was to find an evaluation methodology that captured valid data across all partner languages to demonstrate the extent of the change in knowledge and understanding. Co-development by all team members was a lengthy iterative process, challenged by a lack of consistency in terminology. A mixed methods approach enabled both qualitative and quantitative data to be collected, at the start, during, and at the conclusion of the training for the purposes of evaluation. The module content and evaluation instrument were accessible in each partner country's language. Collecting both types of data provided a high-level snapshot of attainment via the quantitative dataset and an in-depth understanding of the impact of the training from the qualitative dataset. The analysis was mixed methods, with integration at multiple interfaces. The primary focus of the analysis was to support the overall project evaluation for the funding agency. A key project outcome was identifying that the trans-European approach posed several challenges. Firstly, the project partners did not share a first language or a legal or professional approach to domestic abuse and neglect. This was negotiated through complex, systematic, and iterative interaction between team members so that consensus could be achieved. Secondly, the context of the data collection in several different cultural, educational, and healthcare systems across Europe challenged the development of a robust evaluation. The participants in the pilot evaluation shared that the training was contemporary, well-designed, and of great relevance to inform practice. Initial results from the evaluation indicated that the participants were drawn from more than eight partner countries due to the online nature of the training. The primary results indicated a high level of engagement with the content and achievement through the online assessment. The main finding was that the participants perceived the impact of domestic abuse and neglect in very different ways in their individual professional contexts. Most significantly, the participants recognised the need for the training and the gap that existed previously. It is notable that a mixed-methods evaluation of a trans-European project is unusual at this scale.

Keywords: domestic violence, e-learning, health professionals, trans-European

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Authors: Gabriela Dârzan

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This study examines the relationship between subjective executive functioning, memory control, and psychiatric symptoms (anxiety and depression), addressing a critical gap in aligning self-reported executive dysfunction with objective measures of memory suppression. Using the Behavior Rating Inventory of Executive Function – Adult Version (BRIEF-A) and the Think/No-Think (TNT) task, the study evaluates how these measures relate to psychiatric symptoms and assesses suppression-induced forgetting (SIF). Fifty-four adults aged 21–59 first completed the Think/No-Think (TNT) task under Thought Avoidance (TA) and Thought Substitution (TS) conditions, followed by the Behavior Rating Inventory of Executive Function – Adult Version (BRIEF-A), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9). Statistical analyses included correlations, mediation models, and ANOVAs. Results indicated significant correlations between each of the BRIEF-A scales and indices and psychiatric symptoms. Higher self-rated executive dysfunction (Global Executive Composite, Behavioral Regulation Index, and Emotional Control) predicted higher anxiety levels. Similarly, the Global Executive Composite and Material Organization predicted higher depression levels. However, TNT task performance did not correlate with self-reported executive dysfunction, nor did it mediate the relationship between executive functioning and psychiatric symptoms. No significant SIF effect was observed, with no differences between the No-Think and Baseline trials. Additionally, instructional (TA and TS) and test (Independent-Probe - IP and Same-Probe - SP) conditions did not significantly influence thought suppression performance, and the severity of anxiety and depression symptoms did not affect task outcomes. These findings indicate that subjective executive dysfunction is associated with higher anxiety and depression, but memory suppression performance does not demonstrate a mitigating effect on these symptoms. Clinically, interventions focusing on broader executive functioning rather than memory suppression may better address these conditions. Practitioners could explore tailored cognitive strategies and alternative techniques to help patients manage intrusive thoughts effectively.

Keywords: anxiety, depression, subjective executive function, suppression-induced forgetting, think/no-think task

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Authors: Chao Hu, Xinwen Liao, Qing-Hua Qin, Gang Wang

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The hierarchical carbon nanotube (CNT)/carbon fiber (CF)/high density polyethylene (HDPE) was fabricated via compound extrusion and injection molding, in which to author’s best knowledge CNT was employed as a nano-coatings on the surface of CF for the first time by spray coating technique. The CNT coatings relative to CF was set at 1 wt% and the CF content relative to the composites varied from 0 to 25 wt% to study the influence of CNT coatings and CF contents on the mechanical, thermal and morphological performance of this hierarchical composites. The results showed that with the rise of CF contents, the mechanical properties, including the tensile properties, flexural properties, and hardness of CNT/CF/HDPE composites, were effectively improved. Furthermore, the CNT-coated composites showed overall higher mechanical performance than the uncoated counterparts. It can be ascribed to the enhancement of interfacial bonding between the CF and HDPE via the incorporation of CNT, which was demonstrated by the scanning electron microscopy observation. Meanwhile, the differential scanning calorimetry data indicated that by the introduction of CNT and CF, the crystallization temperature and crystallinity of HDPE were affected while the melting temperature did not have an obvious alteration.

Keywords: carbon fibers, carbon nanotubes, extrusion, high density polyethylene

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Authors: Sultanbayeva Gulmira Serikbayevna, Golovchun Aleftina Anatolyevna

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The development of any nation is directly related to the development of human capital in it. A human development is an increase its intellectual potential, its compliance with the requirements of time, present and future society. Demands of globalization cannot limit the processes of national traditions. The education system must be formed on the basis of international practice of cultural development. In Kazakhstan, where modernization changes are rapidly developing, the education system should be formed in two ways: first, on a national basis, and secondly, based on global best practices. There is the need to recognize and promote the importance of education as a value. The world community considers the problem of spiritual values. Along with individual values, spiritual values are also universal values. Formation of values such as the presence in young people a sense of respect for their homeland, social responsibility, respect the culture and traditions of its people is the most important task than the possession of material goods. When forming the intellectual nation, values in the field of education and science become investments for the development of the society, as well as education and science today transformed into the most important capital.

Keywords: human capital, humanitarian technology, intangible assets, intelligent nation, society of knowledge

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Authors: Mohamed Ghoz, Hala Alsabeh

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Context: Macroscopic Nose Macroneedling (MNM) is a new non-surgical procedure for lifting and tightening the nose. It is a tissue-non-invasive technique that uses a needle to create micro-injuries in the skin. These injuries stimulate the production of collagen and elastin, which results in the tightening and lifting of the skin. Research Aim: The research aim of this study was to investigate the efficacy and safety of MNM for the treatment of nasal deformities. Methodology A total of 100 patients with nasal deformities were included in this study. The patients were randomly assigned to either the MNM group or the control group. The MNM group received a single treatment of MNM, while the control group received no treatment. The patients were evaluated at baseline, 6 months, and 12 months after treatment. Findings: The results of this study showed that MNM was effective in improving the appearance of the nose in patients with nasal deformities. At 6 months after treatment, the patients in the MNM group had significantly improved nasal tip projection, nasal bridge height, and nasal width compared to the patients in the control group. The improvements in nasal appearance were maintained at 12 months after treatment. Theoretical Importance: The findings of this study provide support for the use of MNM as a safe and effective treatment for nasal deformities. MNM is a non-surgical procedure that is associated with minimal downtime and no risk of scarring. This makes it an attractive option for patients who are looking for a minimally invasive treatment for their nasal deformities. Data Collection: Data was collected from the patients using a variety of methods, including clinical assessments, photographic assessments, and patient-reported outcome measures. Analysis Procedures: The data was analyzed using a variety of statistical methods, including descriptive statistics, inferential statistics, and meta-analysis. Question Addressed: The research question addressed in this study was whether MNM is an effective and safe treatment for nasal deformities. Conclusion: The findings of this study suggest that MNM is an effective and safe treatment for nasal deformities. MNM is a non-surgical procedure that is associated with minimal downtime and no risk of scarring. This makes it an attractive option for patients who are looking for a minimally invasive treatment for their nasal deformities.

Keywords: nose, surgery, tie, suture

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Authors: Emil Sakharov, Alex Zotov, Ilkin Osmanov, Oleg Shelest, Aleksander Troitskiy, Robert Khabazov

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Objective: Since 2015, our center has been actively implementing methods of surgical correction of atrial fibrillation, in particular, in patients with coronary heart disease. The study presents a comparative analysis of the late postoperative period in patients with coronary artery bypass grafting and atrial fibrillation. Methods: The study included 150 patients with ischemic heart disease and atrial fibrillation for the period from 2015 to 2021. Patients were divided into 2 groups. The first group is represented by patients with ischemic heart disease and atrial fibrillation who underwent coronary bypass surgery and surgical correction of atrial fibrillation (N=50). The second group is represented by patients with ischemic heart disease and atrial fibrillation who underwent only myocardial revascularization (N=100). Patients were comparable in age, gender, and initial severity of the condition. Among the patients in group 1 there were 82% were men, while in the second group, their number was 75%. Among the patients of the first group, there were 36% with persistent atrial fibrillation, 20% with long-term persistent atrial fibrillation. In the second group, 10% with persistent atrial fibrillation and 17% with long-term persistent atrial fibrillation. Results: Average follow-up for groups 1 and 2 amounted to 47 months. There were no complications in group 1, such as bleeding and stroke. There was only 1 patient in group 1, who had died from cardiovascular disease. Freedom of atrial fibrillation was in 82% without AADs therapy. In group 2 there were 8 patients who had died from cardiovascular diseases and total freedom of atrial fibrillation was in 35% of patients, among which 42.8% had additional AADs therapy. Follow-up data are presented in Table 2. Progression of heart failure was observed in 3% in group 1 and 7% in group 2. Combined endpoints (recurrence of AF, stroke, progression of heart failure, myocardial infarction) were achieved in 16% in group 1 and 34% in group 2, respectively. Freedom from atrial fibrillation without antiarrhythmic therapy was 82% for group 1 and 35% for group 2. In the first group, there is a more pronounced decrease in heart failure rates. Deaths from cardiovascular causes were recorded in 2% for group 1 and 7% for group 2. Conclusion: Surgical treatment of atrial fibrillation helps to reduce adverse complications in the late postoperative period and contributes to the regression of heart failure.

Keywords: atrial fibrillation, coronary artery bypass grafting, ischaemic heart disease, heart failure

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Authors: Tadesse Abera

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This study aimed to investigate the contribution of self-advocacy and engagement in the inclusion of SWDs in HEIs. A convergent parallel mixed methods design was employed. This article reports the quantitative strand. A total of 246 SWDs were selected through stratified proportionate random sampling technique from five public HEIs in Ethiopia. Data were collected through Self-advocacy questionnaire, student engagement scale, and college student experience questionnaire and analyzed through frequency, percentage, mean, standard deviation, correlation, one sample t-test and multiple regression. Both self-advocacy and engagement were found to have a predictive power on inclusion of respondents in the HEIs, where engagement was found to be more predictor. From the components of self-advocacy, knowledge of self and leadership and from engagement dimensions sense of belonging, cognitive, and valuing in their respective orders were found to have a stronger predictive power on the inclusion of respondents in the institutions. Based on the findings it was concluded that, if students with disabilities work hard to be self-determined, strive for realizing social justice, exert quality effort and seek active involvement, their inclusion in the institutions would be ensured.

Keywords: self-advocacy, engagement, inclusion, students with disabilities, higher education institution

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Authors: Cheng Xu

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As the metaverse emerges as a dynamic virtual simulacrum of reality, its implications on user privacy have become a focal point of interest. While previous discussions have ventured into metaverse privacy dynamics, a glaring empirical gap persists, especially concerning the effects of personalization in the context of news recommendation services. This study stands at the forefront of addressing this void, meticulously examining how users' privacy concerns shift within the metaverse's personalization context. Through a pre-registered randomized controlled experiment, participants engaged in a personalization task across both the metaverse and traditional online platforms. Upon completion of this task, a comprehensive news recommendation service provider offers personalized news recommendations to the users. Our empirical findings reveal that the metaverse inherently amplifies privacy concerns compared to traditional settings. However, these concerns are notably mitigated when users have a say in shaping the algorithms that drive these recommendations. This pioneering research not only fills a significant knowledge gap but also offers crucial insights for metaverse developers and policymakers, emphasizing the nuanced role of user input in shaping algorithm-driven privacy perceptions.

Keywords: metaverse, privacy concerns, personalization, digital interaction, algorithmic recommendations

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Authors: D. Velayadum, P. Sthandiwe , N. Maharaj, T. Munien, S. Ndamase, G. Zulu, S. Xulu, F. Oosthuizen

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Introduction and aims of the study: It is the responsibility of the pharmacist to manage drug-related problems in order to ensure the greatest benefit to the patient. In order to prevent drug-related morbidity, pharmacists should be aware of medicines that may contribute to certain drug-related problems due to their pharmacological action. In an attempt to assist healthcare practitioners to prevent drug-related morbidity (PDRM), indicators for prevention have been designed. There are currently no indicators available for primary health care in developing countries like South Africa, where the majority of the population access primary health care. There is, therefore, a need to develop such indicators, specifically with the aim of assisting healthcare practitioners in primary health care. Methods: A literature study was conducted to compile a comprehensive list of PDRM indicators as developed internationally using the search engines Google Scholar and PubMed. MESH term used to retrieve suitable articles was 'preventable drug-related morbidity indicators'. The comprehensive list of PDRM indicators obtained from the literature study was further evaluated for face validity. Face validity was done in duplicate by 2 sets of independent researchers to ensure 1) no duplication of indicators when compiling a single list, 2) inclusion of only medication available in primary healthcare, and 3) inclusion of medication currently available in South Africa. Results: The list of indicators, compiled from PDRM indicators in the USA, UK, Portugal, Australia, India, and Canada contained 324 PDRM. 184 of these indicators were found to be duplicates, and the duplications were omitted, leaving a final list of 140. The 140 PDRM indicators were evaluated for face-validity, and 97 were accepted as relevant to primary health care in South Africa. 43 indicators did not comply with the criteria and were omitted from the final list. Conclusion: This study is a first step in compiling a list of PDRM indicators for South Africa. It is important to take cognizance to the fact the health systems differ vastly internationally, and it is, therefore, important to develop country-specific indicators.

Keywords: drug-related morbidity, primary healthcare, South Africa, developing countries

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