Search results for: binary outcomes

Authors: Dercan Gencbas, Hatice Bebis, Sue Moorhead

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In the nursing process, many of the nursing classification systems were created to be used in international. From these, NANDA-I, Nursing Outcomes Classification (NOC) and Nursing Interventions Classification (NIC). In this direction, the main objective of this study is to establish a model for caregivers in hospitals and communities in Turkey and to ensure that nursing outputs are assessed by NOC-based measures. There are many scales to measure Urinary Incontinence (UI), which is very common in children, in old age, vaginal birth, NOC scales are ideal for use in the nursing process for comprehensive and holistic assessment, with surveys available. For this reason, the purpose of this study is to evaluate the validity of the NOC outputs and indicators used for UI NANDA-I. This research is a methodological study. In addition to the validity of scale indicators in the study, how much they will contribute to recovery after the nursing intervention was assessed by experts. Scope validations have been applied and calculated according to Fehring 1987 work model. According to this, nursing inclusion criteria and scores were determined. For example, if experts have at least four years of clinical experience, their score was 4 points or have at least one year of the nursing classification system, their score was 1 point. The experts were a publication experience about nursing classification, their score was 1 point, or have a doctoral degree in nursing, their score was 2 points. If the expert has a master degree, their score was 1 point. Total of 55 experts rated Fehring as a “senior degree” with a score of 90 according to the expert scoring. The nursing interventions to be applied were asked to what extent these indicators would contribute to recovery. For coverage validity tailored to Fehring's model, each NOC and NOC indicator from specialists was asked to score between 1-5. Score for the significance of indicators was from 1=no precaution to 5=very important. After the expert opinion, these weighted scores obtained for each NOC and NOC indicator were classified as 0.8 critical, 0.8 > 0.5 complements, > 0.5 are excluded. In the NANDA-I / NOC / NIC system (guideline), 5 NOCs proposed for nursing diagnoses for UI were proposed. These outputs are; Urinary Continence, Urinary Elimination, Tissue Integrity, Self CareToileting, Medication Response. After the scales are translated into Turkish, the weighted average of the scores obtained from specialists for the coverage of all 5 NOCs and the contribution of nursing initiatives exceeded 0.8. After the opinions of the experts, 79 of the 82 indicators were calculated as critical, 3 of the indicators were calculated as supplemental. Because of 0.5 > was not obtained, no substance was removed. All NOC outputs were identified as valid and usable scales in Turkey. In this study, five NOC outcomes were verified for the evaluation of the output of individuals who have received nursing knowledge of UI and variant types. Nurses in Turkey can benefit from the outputs of the NOC scale to perform the care of the elderly incontinence.

Keywords: nursing outcomes, content validity, nursing diagnosis, urinary incontinence

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Authors: Aliakbar Hafezi, Jalal Taherian, Mahsa Elahi, Jamshid Abedi

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Background: Patients with breast cancer with different molecular subtypes may have different pathological responses to neoadjuvant chemotherapy (NAC). The aim of this study was to evaluate the pathological response to NAC in patients with locally advanced breast cancer based on molecular subtypes. Method: In this retrospective cohort study, 210 female patients with breast cancer candidate for NAC referred to the radiation oncology departments in southern Iran between August 2019 and September 2024 were evaluated in terms of pathologic complete response (pCR) based on immunohistochemical molecular markers (estrogen and progesterone receptors, Her-2/neu and Ki-67), overall survival (OS) and disease-free survival (DFS). Results: The mean age of the patients was 38.22 ± 10.34 years, and 68 patients (32.4%) had a positive family history of breast cancer. The pCR rate was 17.6% (37 patients), which in the subtypes of luminal A, luminal B, Her-2/neu positive and triple negative was 7.7%, 16.9%, 26.5% and 21.05%, respectively. Patients with pCR had significantly better OS (78.4% vs. 49.1%, P = 0.014) and DFS (83.8% vs. 51.4%, P = 0.020) than patients with partial/no pathological response. Conclusion: It seems that the molecular subtype plays a decisive role in the clinical outcome and the pathological response to NAC in patients with locally advanced breast cancer.

Keywords: locally advanced breast cancer, neoadjuvant chemotherapy, pathologic complete response, clinical outcomes

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Authors: N. Pitcheswara Rao

Abstract:

In the process of conveying the information there may be a chance of signal being corrupted which leads to the erroneous bits in the message. The message may consist of single, double and multiple bit errors. In high-reliability applications, memory can sustain multiple soft errors due to single or multiple event upsets caused by environmental factors. The traditional hamming code with SEC-DED capability cannot be address these types of errors. It is possible to use powerful non-binary BCH code such as Reed-Solomon code to address multiple errors. However, it could take at least a couple dozen cycles of latency to complete first correction and run at a relatively slow speed. In order to overcome this drawback i.e., to increase speed and latency we are using reed-Muller code.

Keywords: SEC-DED, BCH code, Reed-Solomon code, Reed-Muller code

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Authors: Muncharee Phaobthip

Abstract:

In this research, the researcher re-examine the mediating effect of employee engagement between its antecedents and consequences for investigates the relation of leadership practices, employment branding and employee engagement based on social exchange theory. As such the researcher has four objectives as follows: First, to study the effects of leadership practices on employment branding, employee engagement and work intention; second, to examine the effects of employer brand perception on employee engagement and work intention; third, to examine the effects of employee engagement on work intention; and last, forth, the researcher inquires into the respondence of work intention. The researcher constituted a sample population of 535 employees of a Thai hotel chain located in four regions of the Kingdom of Thailand (Thailand). The researcher utilized a mixed-methods approach divided into quantitative and qualitative research investigatory phases, respectively. In the quantitative phase of research investigation, the researcher collected germane data from the 535 members of the sample population through the use of a questionnaire as a research instrument. In the qualitative phase of research investigation, relevant data were obtained through carrying out in-depth interviews with three subgroups of members of the sample population. These three subgroups consisted of twelve hotelier experts, six employees at the administrator level, and operational level employees. Focus group discussions were held with discussants from these three subgroups. Findings are as follows: Leadership practices showed positive effects on employment branding, employee engagement, and work intention. Employment branding displayed positive effects on employee engagement and work intention. Employee engagement had positive effects on work intention. However, in the analysis of the equation, the researcher confirmed that the important role of employee engagement is mediator factor between its antecedent and consequence factors. This provides benefits, in that it augments the body of knowledge devoted to the fostering of employee engagement in respect to psychological conditions. In conclusion, the researcher found that the value co-creation between leaders, employers and employees had positive effects on employee outcomes for lead to business outcomes according to reciprocal rule.

Keywords: antecedents, employee engagement, psychological conditions, work intention

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Authors: Amer Ait Sidhoum

Abstract:

Interest in sustainability has gained ground among practitioners, academics and policy-makers due to growing stakeholders’ awareness of environmental and social concerns. This is particularly true for agriculture. However, relatively little research has been conducted on the quantification of social sustainability and the contribution of social issues to the agricultural production efficiency. This research's main objective is to propose a method for evaluating prices of social outputs, more precisely shadow prices, by allowing for the stochastic nature of agricultural production that is to say for production uncertainty. In this article, the assessment of social outputs’ shadow prices is conducted within the methodological framework of nonparametric Data Envelopment Analysis (DEA). An output-oriented directional distance function (DDF) is implemented to represent the technology of a sample of Catalan arable crop farms and derive the efficiency scores the overall production technology of our sample is assumed to be the intersection of two different sub-technologies. The first sub-technology models the production of random desirable agricultural outputs, while the second sub-technology reflects the social outcomes from agricultural activities. Once a nonparametric production technology has been represented, the DDF primal approach can be used for efficiency measurement, while shadow prices are drawn from the dual representation of the DDF. Computing shadow prices is a method to assign an economic value to non-marketed social outcomes. Our research uses cross sectional, farm-level data collected in 2015 from a sample of 180 Catalan arable crop farms specialized in the production of cereals, oilseeds and protein (COP) crops. Our results suggest that our sample farms show high performance scores, from 85% for the bad state of nature to 88% for the normal and ideal crop growing conditions. This suggests that farm performance is increasing with an improvement in crop growth conditions. Results also show that average shadow prices of desirable state-contingent output and social outcomes for efficient and inefficient farms are positive, suggesting that the production of desirable marketable outputs and of non-marketable outputs makes a positive contribution to the farm production efficiency. Results also indicate that social outputs’ shadow prices are contingent upon the growing conditions. The shadow prices follow an upward trend as crop-growing conditions improve. This finding suggests that these efficient farms prefer to allocate more resources in the production of desirable outputs than of social outcomes. To our knowledge, this study represents the first attempt to compute shadow prices of social outcomes while accounting for the stochastic nature of the production technology. Our findings suggest that the decision-making process of the efficient farms in dealing with social issues are stochastic and strongly dependent on the growth conditions. This implies that policy-makers should adjust their instruments according to the stochastic environmental conditions. An optimal redistribution of rural development support, by increasing the public payment with the improvement in crop growth conditions, would likely enhance the effectiveness of public policies.

Keywords: data envelopment analysis, shadow prices, social sustainability, sustainable farming

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Authors: Andrea Parisi, Samantha Vilkins, Luis Furuya-Kanamori, John A. Crump, Benjamin P. Howden, Darren Gray, Kathryn Glass, Martyn Kirk

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Objectives: Salmonella is a leading cause of foodborne enterocolitis worldwide. Nontyphoidal Salmonella (NTS) infections that are Multi-Drug Resistant (MDR) (non-susceptible to ≥1 agent in ≥3 antimicrobial categories) may result in more severe outcomes, although these effects have not been systematically examined. We conducted a systematic review and meta-analysis to examine impacts of MDR NTS on health in high-income settings. Methods: We systematically reviewed the literature from scientific databases, including PubMed, Scopus and grey literature sources, using PRISMA guidelines. We searched for data from case-control studies, cohorts, outbreaks, reports and theses, imposing no language restriction. We included only publications from January 1990 to September 2016 from high income countries as classified by World Bank. We extracted data from papers on duration of illness, hospitalisation rates, morbidity and mortality for MDR and non-MDR NTS strains. Results: After removing duplicates, the initial search revealed 4258 articles. After further screening, we identified 16 eligible studies for the systematic review, and 9 of these were included in meta-analysis. NTS serotypes differed among the reported studies but serotype Typhimurium, Enteritidis, Newport and Heidelberg were among the most often reported as MDR pathogens. Salmonella infections that were MDR were associated with excess bloodstream infections (OR 1.63; 95%CI 1.18-2.26), excess hospitalisations (OR 2.77; 95%CI 1.47-5.21) and higher mortality (OR 3.54; 95%CI 1.10-11.40). Conclusions: MDR NTS infections are a serious public health concern. With the emergence of MDR Salmonella strains in the high-income countries, it is crucial to restrict the use of antimicrobials both in animals and humans, and intervene to prevent foodborne infections.

Keywords: Antimicrobial Resistance, Bloodstream Infection, Health Outcomes, Hospitalisation, Invasive Disease, Multi-Drug Resistance (MDR), Mortality, Nontyphoidal Salmonella

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Authors: Horesh Reinman Netta

Abstract:

Early research on child sexual abuse (CSA) attempted to assess its possible effects. Researchers found that victims of CSA are prone to a host of emotional disorders, including post-traumatic stress disorder, depression, dissociative disorders, anxiety disorders and suicidality later in life. The study examined the development of symptoms over a two-year period at base line and after six months. Factors including the age at the onset of abuse, the gender of the abused child and academic achievements were also examined. Other variables examined include the complex association among self-disclosure, self-esteem, the child’s attachment and coping styles, and psychological adjustment. The abused child’s domestic environment has been found to have a relevant impact on the psychological outcomes of CSA. The study examined inter-parental conflicts, cohesion in the child’s home, parental attachment styles and psychopathology. To the best of our knowledge, no investigation of this nature has yet been performed. Hence, the study makes a major contribution to research in this field. In addition, a combined examination of abuse characteristics, child characteristics, domestic environment and therapeutic history will facilitate enhanced understanding of the interactions among CSA, mediating factors and psychological outcomes.

Keywords: sexual abuse, follow up, victimization, children

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Authors: Pitcheswara Rao Nelapati

Abstract:

In the process of conveying the information there may be a chance of signal being corrupted which leads to the erroneous bits in the message. The message may consist of single, double and multiple bit errors. In high-reliability applications, memory can sustain multiple soft errors due to single or multiple event upsets caused by environmental factors. The traditional hamming code with SEC-DED capability cannot be address these types of errors. It is possible to use powerful non-binary BCH code such as Reed-Solomon code to address multiple errors. However, it could take at least a couple dozen cycles of latency to complete first correction and run at a relatively slow speed. In order to overcome this drawback i.e., to increase speed and latency we are using reed-Muller code.

Keywords: SEC-DED, BCH code, Reed-Solomon code, Reed-Muller code

Procedia PDF Downloads 429

Authors: Malainine Ebnou

Abstract:

This study investigates the effectiveness of using translanguaging techniques in EFL classrooms. The interest in this topic stems from the lack of research on the effectiveness of translanguaging techniques in foreign language learning, both domestically in Japan and globally, as research has focused on translanguaging from a teaching perspective but not much on it from a learning perspective. The main question that the study departs from is whether students’ use of translanguaging techniques can produce better learning outcomes when used at the university level. The sample population of the study is first-year Japanese university students. The study takes an experimental approach where translanguaging is introduced to one group, the experimental group, and withheld from another group, the control group. Both groups will then be assessed and compared to see if the use of translanguaging has had a positive impact on learning. The impact of the research could be in three ways: challenging the prevailing argument that using learners' mother tongue in the classroom is detrimental to the learning process, challenging native speaker-centered approaches in the EFL field, and arguing that translanguaging in EFL classrooms can produce more meaningful learning outcomes. If the effectiveness of translanguaging is confirmed, it will be possible to promote the use of translanguaging in English learning at Japanese universities and contribute to the improvement of students' English, and even lay the foundations for extending the use of translanguaging to people of other ages/nationalities and other languages in the future.

Keywords: translanguaging, EFL, language learning and teaching, applied linguistics

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Authors: Nura Khattab, Fayad Al-Haimus, Teruko Kishibe, Netanel Krugliak, Melissa McGowan, Brodie Nolan

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Trauma-induced coagulopathy remains a significant contributor to mortality in severely injured patients. Fibrinogen is essential for early hemostasis and is recognized as the first coagulation factor to fall below critical levels, compromising the coagulation cascade. Early administration of fibrinogen concentrate may be feasible and effective to prevent coagulopathy. We conducted this scoping review to characterize the existing quantity of literature, and to explore the usage of prehospital fibrinogen concentrate products in improving clinical outcomes in trauma patients. Methods: A search strategy was developed in consultation with an information specialist. We searched MEDLINE, Embase, Cochrane, and Scopus from inception to May 6th 2024. English studies evaluating prehospital/military usage of fibrinogen concentrate in trauma patients were included. Studies were assessed by three independent reviewers for meeting inclusion and exclusion criteria. Reference lists of included articles were reviewed to identify additional studies meeting inclusion criteria. Clinical endpoints regarding fibrinogen concentrate were extracted and synthesized. Results: The literature search returned 1301 articles with seven studies meeting the inclusion criteria. Five studies (71%) were conducted in civilian settings and two studies (29%) were conducted in military settings. Of the included studies, three (43%) utilized a randomized control trial. We identified seven outcomes that compared varying concentrations of fibrinogen or fibrinogen concentrate to a placebo group. The outcomes included overall mortality, death from hemorrhage, thromboembolic events, clotting time, maximum clot firmness, clot stability at ER admission, and fibrinogen concentration at ER admission. Apart from thromboembolic events, all other reported outcomes showed statistically significant differences in group comparisons, determined using p values. The four (57%) non-clinical studies underscored the robustness, practicality, and degree of fibrinogen concentrate utilization in military environments and retrieval services. Conclusion: Preliminary research suggests that prehospital fibrinogen concentrate administration in traumatic bleeding patients is both feasible and effective, improving mortality and clotting parameters. While implementing a time-saving and proactive approach with fibrinogen holds potential for enhancing trauma care, the current evidence is limited. Further studies in this novel field are warranted.

Keywords: fibrinogen concentrate, prehospital, military, trauma, trauma-induced coagulopathy

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Authors: Amirul Adlan, Robert McCulloch, Scott Evans, Michael Parry, Jonathan Stevenson, Lee Jeys

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Background and Objectives: The gastrocnemius myofascial flap is used to manage soft-tissue defects over the anterior aspect of the knee in the context of a patient presenting with a sinus and periprosthetic joint infection (PJI) or extensor mechanism failure. The aim of this study was twofold: firstly, to evaluate the outcomes of gastrocnemius flaps performed by appropriately trained orthopaedic surgeons in the context of PJI and, secondly, to evaluate the infection-free survival of this patient group. Methods: We retrospectively reviewed 30 patients who underwent gastrocnemius flap reconstruction during staged revision total knee arthroplasty for prosthetic joint infection (PJI). All flaps were performed by an orthopaedic surgeon with orthoplastics training. Patients had a mean age of 68.9 years (range 50–84) and were followed up for a mean of 50.4 months (range 2–128 months). A total of 29 patients (97 %) were categorized into Musculoskeletal Infection Society (MSIS) local extremity grade 3 (greater than two compromising factors), and 52 % of PJIs were polymicrobial. The primary outcome measure was flap failure, and the secondary outcome measure was a recurrent infection. Results: Flap survival was 100% with no failures or early returns to theatre for flap problems such as necrosis or haematoma. Overall infection-free survival during the study period was 48% (13 of 27 infected cases). Using limb salvage as the outcome, 77% (23 of 30 patients) retained the limb. Infection recurrence occurred in 48% (10 patients) in the type B3 cohort and 67% (4 patients) in the type C3 cohort (p = 0.65). Conclusion: The surgical technique for a gastrocnemius myofascial flap is reliable and reproducible when performed by appropriately trained orthopaedic surgeons, even in high-risk groups. However, the risks of recurrent infection and amputation remain high within our series due to poor host and extremity factors.

Keywords: gastrocnemius flap, limb salvage, revision arthroplasty, outcomes

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Authors: Darius Singh

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This study adopts a research, develop, and deploy methodology to create a state-of-the-art forest preschool environment using technology and the Gaia (Earth) Education Philosophy as design support. The new philosophy adopts an ancient Greek terminology, “Gaia,” meaning “Mother Earth”, and it take its principle to model everything with the oldest living and breathing entity that it know – Earth. This includes using nature and biomimicry-based principles in building design, environments, curricula, teaching, learning, values and outcomes for children. The study highlights the potential effectiveness of the Gaia (Earth) Education Philosophy as a means of designing Earth-inspired environments for children’s learning. The discuss the strengths of biomimicry-based design principles and propose a curriculum that emphasizes natural outcomes for early childhood learning. Theoretical implications of the study are that the Gaia (Earth) Education Philosophy could serve as a strong foundation for educating young learners.it present a unique approach that promotes connections with Earth-principles and lessons that can contribute to the development of social and environmental consciousness among children and help educate generations to come into a stable and balanced future.

Keywords: earth science, nature education, sustainability, gaia, forest school, nature, inspirational teaching and learning

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Authors: K. S. Poutanen, P. Dussort, A. Erkner, S. Fiszman, K. Karnik, M. Kristensen, C. F. M. Marsaux, S. Miquel-Kergoat, S. Pentikäinen, P. Putz, R. E. Steinert, J. Slavin, D. J. Mela

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Dietary fiber (DF) intake has been associated with lower body weight or less weight gain. These effects are generally attributed to putative effects of DF on appetite. Many intervention studies have tested the effect of DFs on appetite-related measures, with inconsistent results. However, DF includes a wide category of different compounds with diverse chemical and physical characteristics, and correspondingly diverse effects in human digestion. Thus, inconsistent results between DF consumption and appetite are not surprising. The specific contribution of different compounds with varying physico-chemical properties to appetite control and the mediating mechanisms are not well characterized. This systematic review aimed to assess the influence of specific DF characteristics, including viscosity, gel forming capacity, fermentability, and molecular weight, on appetite-related outcomes in healthy humans. Medline and FSTA databases were searched for controlled human intervention trials, testing the effects of well-characterized DFs on subjective satiety/appetite or energy intake outcomes. Studies were included only if they reported: 1) fiber name and origin, and 2) data on viscosity, gelling properties, fermentability, or molecular weight of the DF materials tested. The search generated 3001 unique records, 322 of which were selected for further consideration from title and abstract screening. Of these, 149 were excluded due to insufficient fiber characterization and 124 for other reasons (not original article, not randomized controlled trial, or no appetite related outcome), leaving 49 papers meeting all the inclusion criteria, most of which reported results from acute testing (<1 day). The eligible 49 papers described 90 comparisons of DFs in foods, beverages or supplements. DF-containing material of interest was efficacious for at least one appetite-related outcome in 51/90 comparisons. Gel-forming DF sources were most consistently efficacious but there were no clear associations between viscosity, MW or fermentability and appetite-related outcomes. A considerable number of papers had to be excluded from the review due to shortcomings in fiber characterization. To build understanding about the impact of DF on satiety/appetite specifically there should be clear hypotheses about the mechanisms behind the proposed beneficial effect of DF material on appetite, and sufficient data about the DF properties relevant for the hypothesized mechanisms to justify clinical testing. The hypothesized mechanisms should also guide the decision about relevant duration of exposure in studies, i.e. are the effects expected to occur during acute time frame (related to stomach emptying, digestion rate, etc.) or develop from sustained exposure (gut fermentation mediated mechanisms). More consistent measurement methods and reporting of fiber specifications and characterization are needed to establish reliable structure-function relationships for DF and health outcomes.

Keywords: appetite, dietary fiber, physico-chemical properties, satiety

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Authors: Garba Iliyasu, Lamaran Dattijo

Abstract:

Introduction: Ebola virus disease (EVD) is a disease of humans and other primates caused by Ebola viruses. The most widespread epidemic of EVD in history occurred recently in several West African countries. The burden and outcome of EVD in pregnant women remains uncertain. There are very few studies to date reporting on maternal and fetal outcomes among pregnant women with EVD, hence the justification for this comprehensive review of these published studies. Methods: Published studies in English that reported on maternal and or fetal outcome among pregnant women with EVD up to May 2016 were searched in electronic databases (Google Scholar, Medline, Embase, PubMed, AJOL, and Scopus). Studies that did not satisfy the inclusion criteria were excluded. We extracted the following variables from each study: geographical location, year of the study, settings of the study, participants, maternal and fetal outcome.Result: There were 12 studies that reported on 108 pregnant women and 110 fetal outcomes. Six of the studies were case reports, 3 retrospective studies, 2 cross-sectional studies and 1 was a technical report. There were 91(84.3%) deaths out of the 108 pregnant women, while only 1(0.9%) fetal survival was reported out of 110. Survival rate among the 15 patients that had spontaneous abortion/stillbirth or induced delivery was 100%. Conclusion: There was a poor maternal and fetal outcome among pregnant women with EVD, and fetal evacuation significantly improves maternal survival.

Keywords: Africa, ebola, maternofetal, outcome

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Authors: Yisau Adelaja Odusote, Olakanmi Felix Akinto

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The associative tendency between like atoms in molten Cd-Ga and Cd-In alloy systems has been studied by using the Quasi-Chemical Approximation Model (QCAM). The concentration dependence of the microscopic functions (the concentration-concentration fluctuations in the long-wavelength limits, Scc(0), the chemical short-range order (CSRO) parameter α1 as well as the chemical diffusion) and the mixing properties as the free energy of mixing, GM, enthalpy of mixing and entropy of mixing of the two molten alloys have been determined. Thermodynamic properties of both systems deviate positively from Raoult's law, while the systems are characterized by positive interaction energy. The role of atomic size ratio on the alloying properties was discussed.

Keywords: homo-pairs, interchange energy, enthalpy, entropy, Cd-Ga, Cd-In

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Authors: A. V. Patil

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The microwave dielectric relaxation study of diethanolamine with triethanolamine binary mixture have been determined over the frequency range of 10 MHz to 20 GHz, at various temperatures using time domain reflectometry (TDR) method for 11 concentrations of the system. The present work reveals molecular interaction between same multi-functional groups [−OH and –NH2] of the alkanolamines (diethanolamine and triethanolamine) using different models such as Debye model, Excess model, and Kirkwood model. The dielectric parameters viz. static dielectric constant (ε0) and relaxation time (τ) have been obtained with Debye equation characterized by a single relaxation time without relaxation time distribution by the least squares fit method.

Keywords: diethanolamine, excess properties, kirkwood properties, time domain reflectometry, triethanolamine

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Authors: Kate N. Okeke

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The ever-growing needs of man requiring satisfaction have pushed him strongly towards industrialization which has and is still leaving environmental degradation and its attendant negative impacts in its wake. It is, therefore, not surprising that the enjoyment of fundamental rights like food supply, security of lives and property, freedom of worship, health and education have been drastically affected by such degradation. In recognition of the imperative need to protect the environment and human rights, many global instruments and constitutions have recognized the right to a healthy and sustainable environment. Some environmental advocates and quite a number of literatures on the subject matter call for the recognition of environmental rights via rule of law as a vital means of achieving positive outcomes on the subject matter. However, although there are numerous countries with constitutional environmental provisions, most of them such as Nigeria, have shown poor environmental performance. A notable problem is the fact that the constitution which recognizes environmental rights appears in its other provisions to contradict its provisions by making enforceability of the environmental rights unattainable. While adopting a descriptive, analytical, comparative and explanatory study design in reviewing a successful positive environmental outcome via the rule of law, this article argues that rule of law on a balance of scale, weighs more than just environmental rights recognition and therefore should receive more attention by environmental lawyers and advocates. This is because with rule of law, members of a society are sure of getting the most out of the environmental rights existing in their legal system. Members of Niger-Delta communities of Nigeria will benefit from the environmental rights existing in Nigeria. They are exposed to environmental degradation and pollution with effects such as acidic rainfall, pollution of farmlands and clean water sources. These and many more are consequences of oil and gas exploration. It will also pave way for solving the violence between cattle herdsmen and farmers in the Middle Belt and other regions of Nigeria. Their clashes are over natural resource control. Having seen that environmental rule of law is vital to sustainable development, this paper aims to contribute to discussions on how best the vehicle of rule law can be driven towards achieving positive environmental outcomes. This will be in reliance on other enforceable provisions in the Nigerian Constitution. Other domesticated international instruments will also be considered to attain sustainable environment and development.

Keywords: environment, rule of law, constitution, sustainability

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Authors: Kanika Sood, Sijie Shang

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A fundamental goal of education includes preparing students to become a part of the global workforce by making beneficial contributions to society. In this paper, we analyze student performance for multiple courses that involve different teaching pedagogies: a cooperative learning technique and an inquiry-based learning strategy. Student performance includes student engagement, grades, and attendance records. We perform this study in the Computer Science department for online and in-person courses for 450 students. We will perform correlation analysis to study the relationship between student scores and other parameters such as gender, mode of learning. We use natural language processing and machine learning to analyze student feedback data and performance data. We assess the learning outcomes of two teaching pedagogies for undergraduate and graduate courses to showcase the impact of pedagogical adoption and learning outcome as determinants of academic achievement. Early findings suggest that when using the specified pedagogies, students become experts on their topics and illustrate enhanced engagement with peers.

Keywords: bag-of-words, cooperative learning, education, inquiry-based learning, in-person learning, natural language processing, online learning, sentiment analysis, teaching pedagogy

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Authors: Dana Page, Erica McClure, Kate Snider, Jenni Pollard, Tim Landrum, Jeff Valentine

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Extensive research has been conducted on students with emotional and behavioral disorders (EBD) and their rates of challenging behavior. In the past, however, less attention has been given to their academic achievement and outcomes. Recent research examining outcomes for students with EBD has indicated that these students receive lower grades, are less likely to pass classes, and experience higher rates of school dropout than students without disabilities and students with other high incidence disabilities. Given that between 2% and 20% of the school-age population is likely to have EBD (though many may not be identified as such), this is no small problem. Despite the need for increased examination of this population’s academic achievement, research on the actual performance of students with EBD has been minimal. This study reports the results of a meta-analysis of the limited research examining academic achievement of students with EBD, including effect sizes of assessment scores and discussion of moderators potentially impacting academic outcomes. Researchers conducted a thorough literature search to identify potentially relevant documents before screening studies for inclusion in the systematic review. Screening identified 35 studies that reported results of academic assessment scores for students with EBD. These studies were then coded to extract descriptive data across multiple domains, including placement of students, participant demographics, and academic assessment scores. Results indicated possible collinearity between EBD disability status and lower academic assessment scores, despite a lack of association between EBD eligibility and lower cognitive ability. Quantitative analysis of assessment results yielded effect sizes for academic achievement of student participants, indicating lower performance levels and potential moderators (e.g., race, socioeconomic status, and gender) impacting student academic performance. In addition to discussing results of the meta-analysis, implications and areas for future research, policy, and practice are discussed.

Keywords: students with emotional behavioral disorders, academic achievement, systematic review, meta-analysis

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Authors: Ben Clapperton, Daniel Stahl, Kimberley Goldsmith, Trudie Chalder

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Chronic fatigue syndrome (CFS) is a condition characterised by chronic disabling fatigue and other symptoms that currently can't be explained by any underlying medical condition. Although clinical trials support the effectiveness of cognitive behaviour therapy (CBT), the success rate for individual patients is modest. Patients vary in their response and little is known which factors predict or moderate treatment outcomes. The aim of the project is to develop a prediction model from baseline characteristics of patients, such as demographics, clinical and psychological variables, which may predict likely treatment outcome and provide guidance for clinical decision making and help clinicians to recommend the best treatment. The project is aimed at identifying subgroups of patients with similar baseline characteristics that are predictive of treatment effects using modern cluster analyses and data mining machine learning algorithms. The characteristics of these groups will then be used to inform the types of individuals who benefit from a specific treatment. In addition, results will provide a better understanding of for whom the treatment works. The suitability of different clustering methods to identify subgroups and their response to different treatments of CFS patients is compared.

Keywords: chronic fatigue syndrome, latent class analysis, prediction modelling, self-organizing maps

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Authors: Chaudhary Itisha, Shankar Manu

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Patient satisfaction represents a crucial aspect in the evaluation of health care services. Preoperative teaching provides the patient with pertinent information concerning the surgical process and the intended surgical procedure as well as anticipated patient behavior (anxiety, fear), expected sensation, and the probable outcomes. Although patient education is part of Accreditation protocols, it is not uniform at most places. The aim of this study was to try to assess the benefit of preoperative patient education on selected post-operative outcome parameters; mainly, post-operative pain scores, requirement of additional analgesia, return to activity of daily living and overall patient satisfaction, and try to standardize few education protocols. Dependent variables were measured before and after the treatment on a study population of 302 volunteers. Educational intervention was provided by the Investigator in the preoperative period to the study group through personal counseling. An information booklet contained detailed information was also provided. Statistical Analysis was done using Chi square test, Mann Whitney u test and Fischer Exact Test on a total of 302 subjects. P value <0.05 was considered as level of statistical significance and p<0.01 was considered as highly significant. This study suggested that patients who are given a structured, individualized and elaborate preoperative education and counseling have a better ability to cope up with postoperative pain in the immediate post-operative period. However, there was not much difference when the patients have had almost complete recovery. There was no difference in the requirement of additional analgesia among the two groups. There is a positive effect of preoperative counseling on expected return to the activities of daily living and normal work schedule. However, no effect was observed on the activities in the immediate post-operative period. There is no difference in the overall satisfaction score among the two groups of patients. Thus this study concludes that there is a positive benefit as suggested by the results for pre-operative patient education. Although the difference in various parameters studied might not be significant over a long term basis, they definitely point towards the benefits of preoperative patient education. 

Keywords: patient education, post-operative pain, postoperative outcomes, patient satisfaction

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Authors: Kevin Syam, Devendra K. Chauhan, Mandeep Singh Dhillon

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Background: The posterior horn of medial meniscus (PHMM) is a secondary stabilizer against anterior translation of tibia. Cadaveric studies have revealed increased strain on the ACL graft and greater instrumented laxity in Posterior horn deficient knees. Clinical studies have shown higher prevalence of radiological OA after ACL reconstruction combined with menisectomy. However, functional outcomes in ACL reconstructed knee in the absence of Posterior horn is less discussed, and specific role of posterior horn is ill-documented. This study evaluated functional and radiological outcomes in posterior horn preserved and posterior horn sacrificed ACL reconstructed knees. Materials: Of the 457 patients who had ACL reconstruction done over a 6 year period, 77 cases with minimum follow up of 18 months were included in the study after strict exclusion criteria (associated lateral meniscus injury, other ligamentous injuries, significant cartilage degeneration, repeat injury and contralateral knee injuries were excluded). 41 patients with intact menisci were compared with 36 patients with absent posterior horn of medial meniscus. Radiological and clinical tests for instability were conducted, and knees were evaluated using subjective International Knee Documentation Committee (IKDC) score and the Orthopadische Arbeitsgruppe Knie score (OAK). Results: We found a trend towards significantly better overall outcome (OAK) in cases with intact PHMM at average follow-up of 43.03 months (p value 0.082). Cases with intact PHMM had significantly better objective stability (p value 0.004). No significant differences were noted in the subjective IKDC score (p value 0.526) and the functional OAK outcome (category D) (p value 0.363). More cases with absent posterior horn had evidence of radiological OA (p value 0.022) even at mid-term follow-up. Conclusion: Even though the overall OAK and subjective IKDC scores did not show significant difference between the two subsets, the poorer outcomes in terms of objective stability and radiological OA noted in the absence of PHMM, indicates the importance of preserving this important part of the meniscus.

Keywords: ACL, functional outcome, knee, posterior of medial meniscus

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Authors: Revathi S. Rajan, Pratibha Malik, Nupur Garg, Smitha Avula, Kamini A. Rao

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This study aimed to analyse the pregnancy outcomes in patients with TPO positivity after appropriate L-Thyroxin supplementation with close surveillance. All pregnant women attending the antenatal clinic at Milann-The Fertility Center, Bangalore, India- from Aug 2013 to Oct 2014 whose booking TSH was more than 2.5 mIU/L were included along with those pregnant women with prior hypothyroidism who were TPO positive. Those with TPO positive status were vigorously managed with appropriate thyroxin supplementation and the doses were readjusted every 3 to 4 weeks until delivery. Women with recurrent pregnancy loss were also tested for TPO positivity and if tested positive, were monitored serially with TSH and fT4 levels every 3 to 4 weeks and appropriately supplemented with thyroxin when the levels fluctuated. The testing was done after an informed consent in all these women. The statistical software namely SAS 9.2, SPSS 15.0, Stata 10.1, MedCalc 9.0.1, Systat 12.0 and R environment ver.2.11.1 were used for the analysis of the data. 460 pregnant women were screened for thyroid dysfunction at booking of which 52% were hypothyroid. Majority of them (31.08%) were subclinically hypothyroid and the remaining were overt. 25% of the total no. of patients screened were TPO positive. The various pregnancy complications that were observed in the TPO positive women were gestational glucose intolerance [60%], threatened abortion [21%], midtrimester abortion [4.3%], premature rupture of membranes [4.3%], cervical funneling [4.3%] and fetal growth restriction [3.5%]. 95.6% of the patients who followed up till the end delivered beyond 30 weeks. 42.6% of these patients had previous history of recurrent abortions or adverse obstetric outcome and 21.7% of the delivered babies required NICU admission. Obstetric outcomes in our study in terms of midtrimester abortions, placental abruption, and preterm delivery improved for the better after close monitoring of the thyroid hormone [TSH and fT4] levels every 3 to 4 weeks with appropriate dose adjustment throughout pregnancy. Euthyroid women with TPO positive status enrolled in the study incidentally were those with recurrent abortions/infertility and required thyroxin supplements due to elevated Thyroid hormone (TSH, fT4) levels during the course of their pregnancy. Significant associations were found with age>30 years and Hyperhomocysteinemia [p=0.017], recurrent pregnancy loss or previous adverse obstetric outcomes [p=0.067] and APLA [p=0.029]. TPO antibody levels >600 I U/ml were significantly associated with development of gestational hypertension [p=0.041] and fetal growth restriction [p=0.082]. Euthyroid women with TPO positivity were also screened periodically to counter fluctuations of the thyroid hormone levels with appropriate thyroxin supplementation. Thus, early identification along with aggressive management of thyroid dysfunction and stratification of these patients based on their TPO status with appropriate thyroxin supplementation beginning in the first trimester will aid risk modulation and also help avert complications.

Keywords: TPO antibody, subclinical hypothyroidism, anti nuclear antibody, thyroxin

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Authors: Thien Van Ngo

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The engineering design process is a systematic approach to solving problems. It involves identifying a problem, brainstorming solutions, prototyping and testing solutions, and evaluating the results. The engineering design process can be used to teach students how to solve problems in a creative and innovative way. The research aim of this study was to investigate the effectiveness of using the engineering design process to enhance student learning outcomes in a physics course. A mixed research method was used in this study. The quantitative data were collected using a pretest-posttest control group design. The qualitative data were collected using semi-structured interviews. The sample was 150 first-year students in the Department of Mechanical Engineering Technology at Cao Thang Technical College in Vietnam in the 2022-2023 school year. The quantitative data were collected using a pretest-posttest control group design. The pretest was administered to both groups at the beginning of the study. The posttest was administered to both groups at the end of the study. The qualitative data were collected using semi-structured interviews with a sample of eight students in the experimental group. The interviews were conducted after the posttest. The quantitative data were analyzed using independent sample T-tests. The qualitative data were analyzed using thematic analysis. The quantitative data showed that students in the experimental group, who were taught using the engineering design process, had significantly higher post-test scores on physics problem-solving than students in the control group, who were taught using the conventional method. The qualitative data showed that students in the experimental group were more motivated and engaged in the learning process than students in the control group. Students in the experimental group also reported that they found the engineering design process to be a more effective way of learning physics. The findings of this study suggest that the engineering design process can be an effective way of enhancing student learning outcomes in physics courses. The engineering design process engages students in the learning process and helps them to develop problem-solving skills.

Keywords: engineering design process, problem-solving, learning outcome of physics, students’ physics competencies, deep learning

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Authors: Aneal Khan, Elleine Allapitan, Desmond Koo, Katherine-Ann Piedalue, Shaneel Pathak, Utkarsh Subnis

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Background: Disease management of metabolic, genetic disorders is long-term and can be cumbersome to patients and caregivers. Patient-Reported Outcome Measures (PROMs) have been a useful tool in capturing patient perspectives to help enhance treatment compliance and engagement with health care providers, reduce utilization of emergency services, and increase satisfaction with their treatment choices. Currently, however, PROMs are collected during infrequent and decontextualized clinic visits, which makes translation of patient experiences challenging over time. The GRIT study aims to evaluate a digital health journal application called Zamplo that provides a personalized health diary to record self-reported health outcomes accurately and efficiently in patients with metabolic, genetic disorders. Methods: This is a randomized controlled trial (RCT) (1:1) that assesses the efficacy of Zamplo to increase patient activation (primary outcome), improve healthcare satisfaction and confidence to manage medications (secondary outcomes), and reduce costs to the healthcare system (exploratory). Using standardized online surveys, assessments will be collected at baseline, 1 month, 3 months, 6 months, and 12 months. Outcomes will be compared between patients who were given access to the application versus those with no access. Results: Seventy-seven patients were recruited as of November 30, 2021. Recruitment for the study commenced in November 2020 with a target of n=150 patients. The accrual rate was 50% from those eligible and invited for the study, with the majority of patients having Fabry disease (n=48) and the remaining having Pompe disease and mitochondrial disease. Real-time clinical responses, such as pain, are being measured and correlated to disease-modifying therapies, supportive treatments like pain medications, and lifestyle interventions. Engagement with the application, along with compliance metrics of surveys and journal entries, are being analyzed. An interim analysis of the engagement data along with preliminary findings from this pilot RCT, and qualitative patient feedback will be presented. Conclusions: The digital self-care journal provides a unique approach to disease management, allowing patients direct access to their progress and actively participating in their care. Findings from the study can help serve the virtual care needs of patients with metabolic, genetic disorders in North America and the world over.

Keywords: eHealth, mobile health, rare disease, patient outcomes, quality of life (QoL), pain, Fabry disease, Pompe disease

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Authors: Jonathan E. Oghenekohwo

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The return to scale constitutes a significant investment index in the determination of the quantum of resources that is deployed in investment decision on worker’s continuing professional development. Such investment decision is always predicted on the expected outcomes to the individual, institution and the society in context. Several investments in the development of human capacity on the job have been made, but the return to the scale of such seems not to have been correlated positively with the quantum of resources invested in terms of productivity and performance among workers in many universities. This paper thus found out that, despite the commitment and policy instrument to avail workers the right of continuing professional development, the multiplier effects are not evident in diligence, commitment, honesty, dedication, productivity and improved performance on the job among most administrative staff in Nigerian Universities This author, therefore concludes that, given the policy on the right of workers to get trained on-the job, the outcomes of such training must reflect on the overall performance indices, otherwise, institutions should carry out a forensic analysis of the types of continuing professional development programmes that workers participate in, whether or not, they are consistent with the vision and mission of the institutions in terms of economies of scale of workers professional development to the individual, institution and the nation in context.

Keywords: continuing, professional development, economies of scale, worker’s education, administrative staff

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Authors: Luciano Oliveira, Elsa Vásquez-Alvarez

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The increase in rail freight transport in Brazil in recent years requires new railway lines and the maintenance of existing ones, which generates high costs for concessionaires. It is in this context that this work is inserted, whose objective is to propose a method that uses Binary Linear Programming for the choice of sleeper and rail fastening, from various options, including the way to apply these materials, with focus to minimize costs. Unit value information, the life cycle each of material type, and service expenses are considered. The model was implemented in commercial software using real data for its validation. The formulated model can be replicated to support decision-making for other railway projects in the choice of sleepers and rail fastening with lowest cost.

Keywords: linear programming, rail fastening, rail sleeper, railway

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Authors: Riddhi Jangid, Gajendra Pratap Singh

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Petri nets, a mathematical tool, is used for modeling in different areas of computer sciences, biological networks, chemical systems and many other disciplines. A Petri net model of a given system is created by the graphical representation that describes the properties and behavior of the system. While looking for the behavior of any system, 1-safe Petri nets are of particular interest to many in the application part. Boolean Petri nets correspond to those class in 1- safe Petri nets that generate all the binary n-vectors in their reachability analysis. We study the class by changing different parameters like the token counts in the places and how the structure of the tree changes in the reachability analysis. We discuss here an extended class of Boolean Petri nets that generates n-ary trees in their reachability-based analysis.

Keywords: marking vector, n-vector, petri nets, reachability

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Authors: Fiffy Hanisdah Saikim, Bruce Prideaux

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One of the aims of wildlife tourism is to educate visitors about the threats facing wildlife, in general, and the actions needed to protect the environment and maintain biodiversity. Annually, millions of tourists visit natural areas and zoos primarily to view flagship species such as rhinos and elephants. Venues rely on the inherent charisma of these species to increase visitation and anchor conservation efforts. Expected visitor outcomes from the use of flagships include raised levels of awareness and pro-conservation behaviors. However, the role of flagships in wildlife tourism has been criticized for not delivering conservation benefits for species of interest or biodiversity and producing negative site impacts. Furthermore, little is known about how the connection to a species influences conservation behaviors. This paper addresses this gap in knowledge by extending previous work exploring wildlife tourism to include the emotional connection formed with wildlife species and pro-conservation behaviors for individual species and biodiversity. This paper represents a substantial contribution to the field because (a) it incorporates the role of the experience in understanding how tourists connect with a species and how this connection influences pro-conservation behaviors; and (b) is the first attempt to operationalize Conservation Caring as a measure of tourists’ connection with a species. Existing studies have investigated how specific elements, such as interpretation or species’ morphology may influence programmatic goals or awareness. However, awareness is a poor measure of an emotional connection with an animal. Furthermore, there has not been work done to address the holistic nature of the wildlife viewing experience, and its subsequent influence on behaviors. Results based on the structural equation modelling, support the validity of Conservation Caring as a factor; the ability of wildlife tourism to influence Conservation Caring; and that this connection is a strong predictor of conservation awareness behaviors. These findings suggest wildlife tourism can deliver conservation outcomes. The studies in this paper also provide a valuable framework for structuring wildlife tourism experiences to align with flagship related conservation outcomes, and exploring a wider assemblage of species as potential flagships.

Keywords: wildlife tourism, conservation caring, conservation awareness, structural equation modelling

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Authors: Arosha Rashmi De Silva, Ananda Chandrasekara

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This study seeks to comprehensively examine the influence of fast-food consumption and physical activity levels on the body weight of young employees within the private sector of Sri Lanka. The escalating popularity of fast food has raised concerns about its nutritional content and associated health ramifications. To investigate this phenomenon, a cohort of 100 individuals aged between 25 and 45, employed in Sri Lanka's private sector, participated in this research. These participants provided socio-demographic data through a standardized questionnaire, enabling the characterization of their backgrounds. Additionally, participants disclosed their frequency of fast-food consumption and engagement in physical activities, utilizing validated assessment tools. The collected data was meticulously compiled into an Excel spreadsheet and subjected to rigorous statistical analysis. Descriptive statistics, such as percentages and proportions, were employed to delineate the body weight status of the participants. Employing chi-square tests, our study identified significant associations between fast-food consumption, levels of physical activity, and body weight categories. Furthermore, through binary logistic regression analysis, potential risk factors contributing to overweight and obesity within the young employee cohort were elucidated. Our findings revealed a disconcerting trend, with 6% of participants classified as underweight, 32% within the normal weight range, and a substantial 62% categorized as overweight or obese. These outcomes underscore the alarming prevalence of overweight and obesity among young private-sector employees, particularly within the bustling urban landscape of Colombo, Sri Lanka. The data strongly imply a robust correlation between fast-food consumption, sedentary behaviors, and higher body weight categories, reflective of the evolving lifestyle patterns associated with the nation's economic growth. This study emphasizes the urgent need for effective interventions to counter the detrimental effects of fast-food consumption. The implementation of awareness campaigns elucidating the adverse health consequences of fast food, coupled with comprehensive nutritional education, can empower individuals to make informed dietary choices. Workplace interventions, including the provision of healthier meal alternatives and the facilitation of physical activity opportunities, are essential in fostering a healthier workforce and mitigating the escalating burden of overweight and obesity in Sri Lanka

Keywords: fast food consumption, obese, overweight, physical activity level

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