Search results for: potentially enrolled

Authors: Roshanak Farjad, Amirhossein Hosseini

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Fecal incontinence (FI) is a stressful condition for children and their parents that may affect the patient’s psychological well-being. Evaluating the patients’ psychological status may help physicians manage the disease effectively. This study aimed to assess the emotional and behavioral disturbances in children with FI who were referred to the pediatric gastroenterology clinic in Mofid Children’s Hospital from April 2021 to 2022. This cross-sectional study included children (over four years old) with chronic constipation and fecal incontinence. The diagnosis of chronic constipation and FI were made according to Rome-IV criteria. The Child Behavior Checklist (CBCL) evaluated patients’ emotional, behavioral, and social problems. One hundred one patients with a mean age of 7.96 years were enrolled in the study; 67.32% were males. According to CBCL, 12% (12 patients) indicated emotional and behavioral problems, with CBCL scores in the clinical or at-risk range. We detected anxious/depressed problems in five (4.95%), withdrawn/depressed problems in eight (7.92%), somatic complaints in seven (6.93%), social problems in eight (7.92%), thought problems in nine (8.91%), attention problems in seven (6.93%), rule-breaking behavior in two (1.98%), and aggressive behavior in nine (8.91%) patients. The risk of internalizing and externalizing disorders was reported in four (3.96%) and five (4.95%) patients. Also, eight (7.92%) and seven (6.93%) patients had clinical symptoms of internalizing and externalizing disorders, respectively. There was no significant relationship between patients’ age and gender with the CBCL scores in any subscales. However, there was a significant difference in the total score among the age groups (P = 0.04). The relatively high prevalence of emotional, behavioral, and social problems in our study corroborates the importance of psychological screening of children with FI during the treatment process.

Keywords: chronic constipation, child behavior checklist (CBCL), fecal incontinence, rome-IV criteria

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Authors: Dwitya Elvira, Eryati Darwin

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Background: Graves’ disease (GD) is an autoimmune thyroid disease. Imbalance of Th1/Th2 cells and T-regulatory (Treg)/Th17 cells was thought to play pivotal role in the pathogenesis of GD. Treg FoxP3 produced TGF-β to maintain regulatory function, and Th17 cells produced IL-17 as cytokines that were thought in mediating several autoimmune diseases. The aim of this study is to assess the role of IL-17 and TGF-β in the pathogenesis of GD and to investigate its correlation with Thyroid Stimulating Hormone Receptor Antibody (TRAb) and Treg FoxP3 expression. Method: 30 GD patients and 27 age and sex-matched controls were enrolled in this study. Diagnosis of GD was based on clinical and biochemical of GD. Serum IL-17, TGF-β, TRAb, and FoxP3 were measured by enzyme-linked immunosorbent assay (ELISA). Data were analyzed by using SPSS 21.0 (SPSS Inc.). Spearman rank correlation test was used for assessment of correlation. The statistical significance was accepted as P<0.05. Result: There was no significant correlation between IL-17 and TGF-β serum with expression of FoxP3 level in GD, but there was significant correlation between TGF-β and TRAb serum level (P<0.05). Serum levels of IL-17 and TGF-β were found to be elevated in patient group compared to control, where mean values of IL-17 were 14.43±2.15 pg/mL and TGF-β were 10.44±3.19 pg/mL in patients group; and in control group, level of IL-17 were 7.1±1.45 pg/mL and TGF-β were 4.95±1.35 pg/mL. Conclusion: Serum Il-17 and TGF-β were elevated in GD patients that reflect the role of inflammatory and regulatory cytokines activation in pathogenesis of GD. There was significant correlation between TGF-β and TRAb, revealing that Treg cytokines may play a role in pathogenesis of GD.

Keywords: IL-17, TGF-B, FoxP3, TRAb, Graves’ disease

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Authors: I. Stathopoulos, V. Syrgiamiotis, E. Karavasilis, A. Ploussi, I. Nikas, C. Hatzigiorgi, K. Platoni, E. P. Efstathopoulos

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Introduction: Brain and central nervous system (CNS) tumors form the second most common group of cancer in children, accounting for 30% of all childhood cancers. MRI is the key imaging technique used for the visualization and management of pediatric brain tumors. Initial characterization of tumors from MRI scans is usually performed via a radiologist’s visual assessment. However, different brain tumor types do not always demonstrate clear differences in visual appearance. Using only conventional MRI to provide a definite diagnosis could potentially lead to inaccurate results, and so histopathological examination of biopsy samples is currently considered to be the gold standard for obtaining definite diagnoses. Machine learning is defined as the study of computational algorithms that can use, complex or not, mathematical relationships and patterns from empirical and scientific data to make reliable decisions. Concerning the above, machine learning techniques could provide effective and accurate ways to automate and speed up the analysis and diagnosis for medical images. Machine learning applications in radiology are or could potentially be useful in practice for medical image segmentation and registration, computer-aided detection and diagnosis systems for CT, MR or radiography images and functional MR (fMRI) images for brain activity analysis and neurological disease diagnosis. Purpose: The objective of this study is to provide an automated tool, which may assist in the imaging evaluation and classification of brain neoplasms in pediatric patients by determining the glioma type, grade and differentiating between different brain tissue types. Moreover, a future purpose is to present an alternative way of quick and accurate diagnosis in order to save time and resources in the daily medical workflow. Materials and Methods: A cohort, of 80 pediatric patients with a diagnosis of posterior fossa tumor, was used: 20 ependymomas, 20 astrocytomas, 20 medulloblastomas and 20 healthy children. The MR sequences used, for every single patient, were the following: axial T1-weighted (T1), axial T2-weighted (T2), FluidAttenuated Inversion Recovery (FLAIR), axial diffusion weighted images (DWI), axial contrast-enhanced T1-weighted (T1ce). From every sequence only a principal slice was used that manually traced by two expert radiologists. Image acquisition was carried out on a GE HDxt 1.5-T scanner. The images were preprocessed following a number of steps including noise reduction, bias-field correction, thresholding, coregistration of all sequences (T1, T2, T1ce, FLAIR, DWI), skull stripping, and histogram matching. A large number of features for investigation were chosen, which included age, tumor shape characteristics, image intensity characteristics and texture features. After selecting the features for achieving the highest accuracy using the least number of variables, four machine learning classification algorithms were used: k-Nearest Neighbour, Support-Vector Machines, C4.5 Decision Tree and Convolutional Neural Network. The machine learning schemes and the image analysis are implemented in the WEKA platform and MatLab platform respectively. Results-Conclusions: The results and the accuracy of images classification for each type of glioma by the four different algorithms are still on process.

Keywords: image classification, machine learning algorithms, pediatric MRI, pediatric oncology

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Authors: Asanka Bulathwatta

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This Study tries to figure out the role of emotional Intelligence for developing coping strategies among adolescents who face traumatic events. Late adolescence students who have enrolled into the University education (Bachelor students/first-year students) would be selected as the sample. University education is an important stage of students’ academic life. Therefore, all students need to develop their competencies to attain the goal of passing examinations and also to developing their wisdom related to the scientific knowledge they gathered through their academic life. Study to be conducted in a cross-cultural manner and it will be taking place in Germany and Sri Lanka. The sample will be consisting of 200 students from each country. Late adolescence is a critical period of the human being as it is foot step in their life which acquiring the emotional and social qualities in their social life. There are many adolescents who have affected by aggression related traumatic events during their lifespan but have not been identified or treated. More specifically, there are numerous burning issues within the first year of the university students namely, ragging done by seniors to juniors, bulling, invalidation and issues raise based on attitudes changes and orientation issues. Those factors can be traumatic for both their academic and day to day lifestyle. Identifying the students who are with emotional damages and their resiliency afterward the aggression related traumas and effective rehabilitation from the traumatic events is immensely needed in order to facilitate university students for their academic achievements and social life within the University education. Research findings in Germany show that students shows more interpersonal traumas, life-threatening illnesses and death of someone related are common in German sample.

Keywords: emotional intelligence, agression, trauma, coping

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Authors: Dipanshu Sur, Ratnabali Chakravorty

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Introduction: Polycystic ovary syndrome (PCOS) is the most common metabolic abnormality such as changes in lipid profile, diabetes, hypertension and metabolic syndrome occurring in women. Hypovitaminsis D was found to be associated with the development of obesity and insulin resistance in women with PCOS. Aim: To evaluate the association of vitamin D levels in obese and non-obese patients with PCOS in an East Indian populations. Methods: A case control study was conducted. It enrolled 100 cases of PCOS based on Rotterdam criteria and 100 ovulatory normal cases matched for their age and BMI. Vitamin D levels were compared in the obese and non-obese PCOS groups and also with the controls. Results: The mean age of subjects was 29.48 ± 3.29 years in the PCOS group and 26.24 ± 2.56 years in the control group. Hypovitaminosis D was present in 75 out of 100 PCOS women (75.0%) and 25 women (25.0%) showed sufficient 25OHD levels ≥30 ng/ml. Women with PCOS had significantly lower total serum calcium (8.4 ± 0.25 mg/dl versus 9.8 ± 0.17 mg/dl in controls), and 25 OHD (21.2 ± 2.56 ng/ml versus 32.6 ± 2.23 ng/ml in control group) than ovulatory normal women. This difference remained significant for both groups after adjustment for BMI. Obese women in both groups had significantly lower concentration of calcium and 25OHD than normal weight patients in this study. Conclusion: Our study shows majority of the patients and controls had vitamin D deficiency and there was significant difference in the vitamin D levels in PCOS group and controls as well as obese and non-obese groups. This may reflect the vitamin D deficiency status of the community. Vitamin D deficiency should demands immediate attention as it is a severe problem among the East Indian population.

Keywords: vitamin D deficiency, polycystic ovary syndrome, obese, hypovitaminsis D

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Authors: Suchana Marahatta, Sabina Bhattarai, Bishnu Hari Paudel, Dilip Thakur

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Background: Every year thousands of patients develop nerve damage and disabilities as a result of leprosy which can be prevented by early detection and treatment. So, early detection and treatment of nerve function impairment is of paramount importance in leprosy. Objectives: To assess the electrophysiological pattern of the peripheral nerves in leprosy patients and to compare it with clinical assessment tools. Materials and Methods: In this comparative cross-sectional study, 74 newly diagnosed leprosy patients without reaction were enrolled. They underwent thorough evaluation for peripheral nerve function impairment using clinical tests [i.e. nerve palpation (NP), monofilament (MF) testing, voluntary muscle testing (VMT)] and nerve conduction study (NCS). Clinical findings were compared with that of NCS using SPSS version 11.5. Results: NCS was impaired in 43.24% of leprosy patient at the baseline. Among them, sensory NCS was impaired in more patients (32.4%) in comparison to motor NCS (20.3%). NP, MF, and VMT were impaired in 58.1%, 25.7%, and 9.4% of the patients, respectively. Maximum concordance of monofilament testing and sensory NCS was found for sural nerve (14.7%). Likewise, the concordance of motor NP and motor NCS was the maximum for ulnar nerve (14.9%). When individual parameters of the NCS were considered, amplitude was found to be the most frequently affected parameter for both sensory and motor NCS. It was impaired in 100% of cases with abnormal NCS findings. Conclusion: Since there was no acceptable concordance between NCS findings and clinical findings, we should consider NCS whenever feasible for early detection of neuropathy in leprosy. The amplitude of both sensory nerve action potential (SNAP) and compound nerve action potential (CAMP) could be important determinants of the abnormal NCS if supported by further studies.

Keywords: leprosy, nerve function impairment, neuropathy, nerve conduction study

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Authors: Asli Yagmur Akbulut

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Despite a robust and growing job market and lucrative salaries, there is a global shortage of Information Technology (IT) professionals. To make matters worse, women continue to be underrepresented in the IT workforce and among IT degree holders. In today’s knowledge based economy and society, it is extremely important to increase the presence of women in the IT field. In order to do so, it is necessary to reduce entry barriers and attract more women to pursue degrees in various IT fields including the field of Management Information Systems (MIS). Even though MIS is considered to have a more feminine nature, women still tend to avoid majoring in this field. Unfortunately, there is a lack of research that investigates the specific factors that may deter women from pursuing a degree in MIS. To address this research gap, this study examined a set of key environmental barriers that might prevent women from pursuing an MIS degree and explored whether there were any gender differences between female and male students in terms of these key barriers. Based on a survey of 280 students enrolled in an introductory level MIS course, the study empirically confirmed that there were significant differences between male and female students in terms of the key contextual barriers perceived. Female students demonstrated major concerns about gender discrimination related barriers, whereas male students were more concerned about negative social influences. Both male and female students were equally concerned about not being able to fit in well with other MIS majors. The findings have important implications for MIS programs, as the information gained can be used to design and implement specific intervention strategies to overcome the barriers and attract larger pools of women to the MIS discipline. The paper concludes with a discussion of the findings, implications, and future research directions.

Keywords: gender differences, MIS major, underrepresentation, women in IT

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Authors: Hameed Ullah, Karim Elakabawi, Han KE, Najeeb Ullah, Habib Ullah, Sardar Ali Shah, Hamad Haider Khan, Muhammad Asad Khan, Ning Guo, Zuyi Yuan

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Background: Predictors of decreased fractional flow reserve at left circumflex coronary artery after left main (LM) crossover stenting are still lacking. The objectives of the present study were to provide the predictors for low Fractional flow reserve (FFR) at coronary artery (LCx) and the possible treatment strategies for the compromised LCx-together with their long term outcomes. Methods: A total of 563 included patients out of 1974 patients admitted to our hospital from February 2015 to November 2020 with significant distal LM-bifurcation lesions. The enrolled patients underwent single-stent cross-over PCI under IVUS guidance with further LCx intervention as indicated by measured FFR. Results: The included patients showed angiographic significant LCx ostial affection after LM-stenting, but only 116 (20.6%) patients had FFR <0.8. The 3-year composite MACE rates were comparable between the high and low FFR groups (16.8% vs. 15.5%, respectively; P=0.744). In a multivariable analysis, a low FFR in the LCx was associated with post-stenting MLA of the LCx (OR: 0.032, P <0.001), post-stenting LCx-plaque burden (OR: 1.166, P <0.001), post-stenting LM-MLA (OR: 0.821, P =0.038) and pre-stenting LCx-MLA (OR: 0.371, P =0.044). In patients with low FFR, management of compromised LCx with DEB had the lowest 3-year MACE rate (8.1%) as compared to either KBI (17.5%) or stenting group (20.5%), P =0.299. Conclusion: FFR-guided LCx intervention can avoid unnecessary LCx intervention. The post-stenting predictors of low FFR include post-stenting MLA and plaque burden of the LCx and MV stent length. The 3-year MACE rates were comparable between high FFR patients and patients who had low FFR and were adequately managed.

Keywords: fractional flow reserve, left main stem, percutaneous coronary interventions, intravascular ultrasound

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Authors: Costrie Ganes Widayanti

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Learning Disabilities (LDs) are less understood by the Indonesia’s educational practitioners. As a result, students with LDs are at risk of being outcast from the learning process that requires participation, which potentially disconnects them academically and socially. Its objective is to raise the voice of students with LDs regarding their engagement in the classroom. This research is conducted in two urban regular public primary schools in Indonesia. The study uses an ethnographic case study research design, which explores the views and experiences of four (4) students with LDs. The data were collected using participant observations and interviews. The preliminary findings highlighted two areas: 1) the stigmatization about LDs; and 2) perceived membership. Having LDs was a barrier to fully engage in the academic and social life. Interestingly, they were more likely dependent on each other for support as limited assistance was offered by teachers and peers. Their peers did not take a keen interest in helping them when they found difficulties with the assignments. Furthermore, due to their low academic performance, they were not in favor of being nominated as a group member. In a situation that required them to do a group assignment, they were not expected to give a contribution, positioning themselves as incompatible. These findings indicated that such practices legitimate the hegemony of the superior over those who are powerless and left behind.

Keywords: engagement, experiences, learning disability, qualitative design

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Authors: Sucharat Limsitthichaikoon, Kedsarin Saodaeng, Aroonsri Priprem, Teerasak Damrongrungruang

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Complexation of anthocyanins to mimic natural copigmentation process was investigated. Cyanidin-rich extracts from Zea mays L. CeritinaKulesh. anddelphinidin-rich extracts from ClitoriaternateaL. were used to form 4 anthocyanin complexes, AC1, AC2, AC3, and AC4, in the presence of several polyphenols and a trace metal. Characterizations of the ACs were conducted by UV, FTIR, DSC/TGA and morphological observations. Bathochromic shifts of the UV spectra of 4 formulas of ACs were observed at peak wavelengths of about 510-620 nm by 10 nm suggesting complex formation.FTIR spectra of the ACs indicate shifts of peaks from 1,733 cm-1 to 1,696 cm-1 indicating interactions and a decrease in the peak areas within the wavenumber of 3,400-3,500 cm-1 indicating changes in hydrogen bonding.Thermal analysis of all of the ACs suggests increases in melting temperature after complexation. AC with the highest melting temperature was morphologically observed by SEM and TEM to be crystal-like particles within a range of 50 to 200 nm. Particle size analysis of the AC by laser diffraction gave a range of 50-600 nm, indicating aggregation. This AC was shown to have no cytotoxic effect on cultured HGEPp0.5 and HGF (all p> 0.05) by MTT. Therefore, complexation of anthocyanins was simple and self-assembly process, potentially resulting in nanosized particles of anthocyanin complex.

Keywords: anthocyanins, complexation, purple corn cops, butterfly pea, physicochemical characteristics, cytotoxicity

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Authors: Eric Sanchis

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Although there does not exist a definitive consensus on a precise definition of a complex system, it is generally considered that a system is complex by nature. The presented work illustrates a different point of view: a system becomes complex only with regard to the question posed to it, i.e., with regard to the problem which has to be solved. A complex system is a couple (question, object). Because the number of questions posed to a given object can be potentially substantial, complexity does not present a uniform face. Two types of complex systems are clearly identified: first-order complex systems and second-order complex systems. First-order complex systems physically exist. They are well-known because they have been studied by the scientific community for a long time. In second-order complex systems, complexity results from the system composition and its articulation that are partially unknown. For some of these systems, there is no evidence of their existence. Vagueness is the keyword characterizing this kind of systems. Autonomy and free will, two mental productions of the human cognitive system, can be identified as second-order complex systems. A classification based on the properties structure makes it possible to discriminate complex properties from the others and to model this kind of second order complex systems. The final outcome is an implementable synthetic property that distinguishes the solid aspects of the actual property from those that are uncertain.

Keywords: autonomy, free will, synthetic property, vaporous complex systems

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Authors: Pooja Sanathkumar, Srinidhi Murali, Sethuraman TV, Saravanan M, Paventhan Arumugam, Ashwin Ashok

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The last decade has witnessed a significant interest in visible light communication (VLC) technology, as VLC can potentially achieve high data rate links and secure communication channels. However, the use of VLC under mobile settings is fundamentally limited as its a line-of-sight (LOS) technology and there has been limited breakthroughs in realizing VLC for mobile settings. In this regard, this work targets to study the VLC channel under mobility. Through a use-case study analysis with experiment data traces this paper presents an empirical VLC channel study considering the application of VLC for smart lighting in an indoor room environment. This paper contributes a calibration study of a prototype VLC smart lighting system in an indoor environment and through the inferences gained from the calibration, and considering a user is carrying a mobile device fit with a VLC receiver, this work presents recommendations for user's position adjustments, with the goal to ensure maximum connectivity across the room.

Keywords: visible light communication, mobility, empirical study, channel characterization

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Authors: Pablo Zoghbi-Manrique-de-Lara, Miguel A. Suárez-Acosta

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The goal of the present paper is to model two classic lines of research in which employees starred, organizational justice and citizenship behaviour (OCB), but that have never been studied together when targeting customers. The suggestion is made that a hotel’s fair treatment (in terms of distributive, procedural, and interactional justice) toward customers will be appreciated by the employees, who will reciprocate in kind by favouring the hotel with increased customer-oriented behaviours (COBs). Data were collected from 204 employees at eight upscale hotels in the Canary Islands (Spain). Unlike in the case of perceptions of distributive justice, results of structural equation modelling demonstrate that employees substantively react to interactional and procedural justice toward guests by engaging in customer-oriented behaviours (COBs). The findings offer new reasons why employees decide to engage in COBs, and they highlight potentially beneficial effects of fair treatment toward guests bring to hospitality through promoting COBs.

Keywords: hotel guests’ (mis) treatment, customer-oriented behaviours, employee citizenship, organizational justice, third-party observers, third-party intervention

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Authors: S. Fazi, B. Behdani

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The inland transportation of maritime containers entails the use of different modalities whose capacity is typically booked in advance. Containers may miss their scheduled departure time at a terminal for several reasons, such as delays, change of transport modes, multiple bookings pending. In those cases, it may be difficult for transport service providers to find last minute containers to fill the vacant capacity. Similarly to other industries, overbooking could potentially limit these drawbacks at the cost of a lower service level in case of actual excess of capacity in overbooked rides. However, the presence of multiple modalities may provide the required flexibility in rescheduling and limit the dissatisfaction of the shippers in case of containers in overbooking. This flexibility is known with the term 'synchromodality'. In this paper, we evaluate via discrete event simulation the application of overbooking. Results show that in certain conditions overbooking can significantly increase profit and utilization of high-capacity means of transport, such as barges and trains. On the other hand, in case of high penalty costs and limited no-show, overbooking may lead to an excessive use of expensive trucks.

Keywords: discrete event simulation, flexibility, inland shipping, multimodality, overbooking

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Authors: Daniel Schimmelpfennig

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This paper attempts to delineate the idea to curate the leveling up for whole-systems change. Curation is the act fo select, organize, look after, or present information from a professional point of view through expert knowledge. The trans-paradigmatic, trans-contextual, trans-disciplinary, trans-perspective of trans-media futures studies hopes to enable a move from a monochrome intellectual pursuit towards breathing a higher dimensionality. Progressing to the next level to equip actors for whole-systems change is in consideration of the commonly known symptoms of our time as well as in anticipation of future challenges, both a necessity and desirability. Systems of collective intelligence could potentially scale regenerative, adaptive, and anticipatory capacities. How could such a curation then be enacted and implemented, to initiate the process of leveling-up? The suggestion here is to focus on the metasystem transition, the bio-digital fusion, namely, by merging neurosciences, the ontological design of money as our operating system, and our understanding of the billions of years of time-proven permutations in nature, biomimicry, and biological metaphors like symbiogenesis. Evolutionary cybernetics accompanies the process of whole-systems change.

Keywords: bio-digital fusion, evolutionary cybernetics, metasystem transition, symbiogenesis, transmedia futures studies

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Authors: Mei Han, Jinkou Zhao, Yuan Yao, Liangui Feng, Xianbin Ding, Guohui Wu, Chao Zhou, Lin Ouyang, Rongrong Lu, Bo Zhang

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To compare the HIV incidence estimated using BED capture enzyme linked immunosorbent assay (BED-CEIA) and observed in a cohort against the HIV incidence among men who have sex with men (MSM) measured by pooling polymerase chain reaction (pooling-PCR). A total of 617 MSM subjects were included in a respondent driven sampling survey in Chongqing in 2008. Among the 129 that were tested HIV antibody positive, 102 were defined with long-term infection, 27 were assessed for recent HIV infection (RHI) using BED-CEIA. The remaining 488 HIV negative subjects were enrolled to the prospective cohort and followed-up every 6 months to monitor HIV seroconversion. All of the 488 HIV negative specimens were assessed for acute HIV infection (AHI) using pooling-PCR. Among the 488 negative subjects in the open cohort, 214 (43.9%) were followed-up for six months, with 107 person-years of observation and 14 subjects seroconverted. The observed HIV incidence was 12.5 per 100 person-years (95% CI=9.1-15.7). Among the 488 HIV negative specimens, 5 were identified with acute HIV infection using pooling-PCR at an annual rate of 14.02% (95% CI=1.73-26.30). The estimated HIV-1 incidence was 12.02% (95% CI=7.49-16.56) based on BED-CEIA. The HIV incidence estimated with three different approaches was different among subgroups. In the highly HIV prevalent MSM, it costs US$ 1724 to detect one AHI case, while detection of one case of RHI with BED assay costs only US$ 42. Three approaches generated comparable and high HIV incidences, pooling PCR and prospective cohort are more close to the true level of incidence, while BED-CEIA seemed to be the most convenient and economical approach for at-risk population’s HIV incidence evaluation at the beginning of HIV pandemic. HIV-1 incidences were alarmingly high among MSM population in Chongqing, particularly within the subgroup under 25 years of age and those migrants aged between 25 to 34 years.

Keywords: BED-CEIA, HIV, incidence, pooled PCR, prospective cohort

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Authors: Kimberlyn Greene

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Employers today expect college graduates to not only develop and demonstrate content-specific knowledge but also 21st century skillsets such as critical thinking. International assessments suggest students enrolled in United States (U.S.) educational institutions are underperforming in comparison to their global peers in areas such as critical thinking and technology. This multi-case study examined how undergraduate digital literacy courses at a four-year university in the U.S., as implemented by instructors, fostered students’ development of critical thinking skills. The conceptual framework for this study presumed that as students engaged in complex thinking within the context of a digital literacy course, their ability to deploy critical thinking was contingent upon whether the course was designed with the expectation for students to use critical thinking skills as well as the instructor’s approach to implementing the course. Qualitative data collected from instructor interviews, classroom observations, and course documents were analyzed with an emphasis on exploring the course design and instructional methods that provided opportunities to foster critical thinking skill development. Findings from the cross-case analysis revealed that although the digital literacy courses were designed and implemented with the expectation students would deploy critical thinking; there was no explicit support for students to develop these skills. The absence of intentional skill development resulted in inequitable opportunities for all students to engage in complex thinking. The implications of this study suggest that if critical thinking is to remain a priority, then universities must expand their support of pedagogical and instructional training for faculty regarding how to support students’ critical thinking skill development.

Keywords: critical thinking skill development, curriculum design, digital literacy, pedagogy

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Authors: Yi Meng, YunGao

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Having been studied and worked in North America and Europe, we, two Chinese art educators, have been enormously influenced by eastern and western cultures. Thus, we aim to enhance students’ learning experiences by exploring and amalgamating both cultures for art creating. This text draws on our action research study of students’ visual literacy practices in a foundation sketching course in a major Chinese university, exploring art forms by cross-utilizing various cultural aspects. Instead of relying on the predominant western observational drawing skills in our classroom, we taught students about ancient Chinese art in the provincial museum, using Fu Hao owl-shaped vessel, a Shang Dynasty national treasure, as the final sketch project of this course. We took up multimodal literacy, which emphasized students’ critical use of creativity to exploit the semiotic potentials of communicative modes to address diverse cultural issues through their multimodal design. We used the Hong Kong-based artist Tik Ka’s artworks to demonstrate the cultural amalgamation of Chinese traditions and western pop cultures. Collectively, these approaches create a dialogical space for students to experience, analyze, and negotiate with complex modes and potentially transform their understanding of both cultures by redesigning Fu Hao.

Keywords: Chinese traditions, western pop cultures, Fu Hao, arts education, design sketch

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Authors: Aicha Akrout, Amira Echtioui, Mohamed Ghorbel

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Pneumonia remains a significant global health concern, posing a substantial threat to human lives due to its contagious nature and potentially fatal respiratory complications caused by bacteria, fungi, or viruses. The reliance on chest X-rays for diagnosis, although common, often necessitates expert interpretation, leading to delays and potential inaccuracies in treatment. This study addresses these challenges by employing transfer learning techniques to automate the detection of lung diseases, with a focus on pneumonia. Leveraging three pre-trained models, VGG-16, ResNet50V2, and MobileNetV2, we conducted comprehensive experiments to evaluate their performance. Our findings reveal that the proposed model based on VGG-16 demonstrates superior accuracy, precision, recall, and F1 score, achieving impressive results with an accuracy of 93.75%, precision of 94.50%, recall of 94.00%, and an F1 score of 93.50%. This research underscores the potential of transfer learning in enhancing pneumonia diagnosis and treatment outcomes, offering a promising avenue for improving healthcare delivery and reducing mortality rates associated with this debilitating respiratory condition.

Keywords: chest x-ray, lung diseases, transfer learning, pneumonia detection

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Authors: Margaret S. Wright

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Background/Significance: During many recent public health emergencies/disasters, public health nursing data has been missing or delayed, potentially impacting the decision-making and response. Data used as evidence for decision-making in response, planning, and mitigation has been erratic and slow, decreasing the ability to respond. Methodology: Applying best practices in data management and data use in public health settings, and guided by the concepts outlined in ‘Disaster Standards of Care’ models leads to the development of recommendations for a model of best practices in data management and use in public health disasters/emergencies by public health nurses. As the ‘patient’ in public health disasters/emergencies is the community (local, regional or national), guidelines for patient documentation are incorporated in the recommendations. Findings: Using model public health nurses could better plan how to prepare for, respond to, and mitigate disasters in their communities, and better participate in decision-making in all three phases bringing public health nursing data to the discussion as part of the evidence base for decision-making.

Keywords: data management, decision making, disaster planning documentation, public health nursing

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Authors: Jelena Maletkovic

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Background: Endogenous Cushing’s syndrome is a rare disease, but iatrogenic or drug related Cushing syndrome from glucocorticoid products is commonly seen in clinical practice. With high dose and long term use of glucocorticoids, patients can develop isolated hypothalamic-pituitary-adrenal (HPA) suppression, or HPA axis suppression can be accompanied by overt iatrogenic Cushing’s syndrome. This is a rare case where severe Cushing’s syndrome developed from an unknown medication and was followed by severe and prolonged adrenal insufficiency and multiple potentially fatal complications. Case: This is a 37-year-old woman who is presented to Emergency Room (ER) with shortness of breath and chest pain. Four months prior to this presentation the patient was a generally healthy woman who was looking for improvement in her appearance and visited local Rejuvenation Clinic. After initial consultation with a nurse, she was contacted by a physician over the phone and was advised to start taking multiple injectable medications that will arrive by mail. Medications without any labels on bottles were delivered and the patient started daily intramuscular injections. Over the next two months, she noticed rounding of her face and swelling around her eyes. She gained 20 pounds, mostly abdominal fat and became extremely fatigued. Her muscles on legs were visibly decreasing in size and she felt significant muscle weakness. Unexplained bruising occurred. She started growing hair on face and developed secondary amenorrhea. New severe back pain started. She developed depression and headaches. Finally, over a few days, a number of red-purple stretch marks that were sensitive and painful appeared over her abdomen, upper part of arms and legs. She then became suspicious that these dramatic symptoms are caused by injectable medication and she discontinued injections. Over the next few days she presented to ER with low blood pressure and oxygen saturation of 75%. Studies revealed extensive pneumonia as well as multiple pulmonary emboli. Her white blood count was elevated with 32 000 and she also had acute kidney failure on admission. She was treated for sepsis and was also given stress dose steroids. Steroids were tapered over 48 hours and discontinued. After being discharged to home, on her first visit to endocrinology clinic she had undetectable ACTH of < 2pg/mL and undetectable 8am cortisol of < 0.2mcg/dL. She did not respond to an intramuscular injection of cosyntropin 250mcg and her repeated cortisol after 60 minutes was only 1mcg/dL. The patient was diagnosed with adrenal insufficiency and was started on hydrocortisone 20mg+10mg. It took close to 2 years of slow tapering for recovery of this patient’s HPA axis and resolve all the sequelae from Cushing’s syndrome. Conclusion: Misuse and abuse of glucocorticoids have been present almost since these medications were discovered. This is a rare case where not only severe Cushing’s syndrome in full clinical picture developed but also the patient suffered multiple potentially fatal complications and prolonged adrenal insufficiency. Visits to herbal, rejuvenation, esthetic, and similar clinics are becoming more and more popular and physicians need to be aware of possible non-benign nature of medications that their patients may be using.

Keywords: iatrogenic, Cushing's syndrome, adrenal crisis, steroid abuse

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Authors: Azza H. El-Medany, Hanan H. Hagar, Omnia A. Nayel, Jamila H. El-Medany

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In search for drugs that can target cancer cell micro-environment in as much as being able to halt malignant cellular transformation, the natural dietary phytochemical curcumin was currently assessed in DMH-induced colorectal cancer rat model. The study enrolled 50 animals divided into a control group (n=10) and DMH-induced colorectal cancer control group (n=20) (20mg/kg-body weight for 28 weeks) versus curcumin-treated group (n=20) (160 mg/kg suspension daily oral for further 8 weeks). Treatment by curcumin succeeded to significantly decrease the percent of ACF and tended to normalize back the histological changes retrieved in adenomatous and stromal cells induced by DMH. The drug also significantly elevated GSH and significantly reduced most of the accompanying biochemical elevations (namely MDA, TNF-α, TGF-β and COX2) observed in colonic carcinomatous tissue, induced by DMH, thus succeeding to revert that of MDA, COX2 and TGF-β back to near normal as justified by being non-significantly altered as compared to normal controls. The only exception was PAF that was insignificantly altered by the drug. When taken together, it could be concluded that curcumin possess the potentiality to halt some of the orchestrated cross-talk between cancerous transformation and its micro-environmental niche that contributes to cancer initiation, progression and metastasis in this experimental cancer colon model. Envisioning these merits to a drug with already known safety preferentiality, awaits final results of current ongoing clinical trials, before curcumin can be added to the new therapeutic armamentarium of anticancer therapy.

Keywords: curcumin, dimethyl hydralazine, aberrant crypt foci, malondialdehyde, reduced glutathione, cyclooxygenase-2, tumour necrosis factor-alpha, transforming growth factor-beta, platelet activating factor

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Authors: Alain Gholam

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Visual thinking routines are principles based on several theories, approaches, and strategies. Such routines promote thinking skills, call for collaboration and sharing of ideas, and above all, make thinking and learning visible. Visual thinking routines were implemented in the teaching methodology graduate course at the American University in Dubai. The study used mixed methods. It was guided by the following two research questions: 1). To what extent do visual thinking inspire learning in the classroom, and make time for students’ questions, contributions, and thinking? 2). How do visual thinking routines inspire learning in the classroom and make time for students’ questions, contributions, and thinking? Eight student teachers enrolled in the teaching methodology course at the American University in Dubai (Spring 2017) participated in the following study. First, they completed a survey that measured to what degree they believed visual thinking routines inspired learning in the classroom and made time for students’ questions, contributions, and thinking. In order to build on the results from the quantitative phase, the student teachers were next involved in a qualitative data collection phase, where they had to answer the question: How do visual thinking routines inspire learning in the classroom and make time for students’ questions, contributions, and thinking? Results revealed that the implementation of visual thinking routines in the classroom strongly inspire learning in the classroom and make time for students’ questions, contributions, and thinking. In addition, student teachers explained how visual thinking routines allow for organization, variety, thinking, and documentation. As with all original, new, and unique resources, visual thinking routines are not free of challenges. To make the most of this useful and valued resource, educators, need to comprehend, model and spread an awareness of the effective ways of using such routines in the classroom. It is crucial that such routines become part of the curriculum to allow for and document students’ questions, contributions, and thinking.

Keywords: classroom display, student engagement, thinking classroom, visual thinking routines

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Authors: Welawat Tienpratarn, Chaiyaporn Yuksen, Kasamon Aramvanitch, Karn Suttapanit, Yahya Mankong, Nussareen Yaemluksanalert, Sansanee Meesawad

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Introduction : Application of a rigid cervical collar may interfere with the laryngeal view, and potentially lead to failed endotracheal intubation (ETI). This study aimed to compare intubation success rates while performing inline stabilization with and without cervical hard collar. Methods : This randomized prospective comparative study included paramedics working in the Department of Emergency Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand to compare the success rates of endotracheal intubation on manikin using inline stabilization with and without cervical hard collar. Results : 125 participants were evaluated; 63 in the rigid cervical collar and 62 in the non-cervical hard collar group. The rate of successful intubation was significantly higher using manual stabilization without cervical hard collar (61 (96.8%) vs. 55 (88.7%); p=0.048). The time required to successfully perform intubation was also shorter, with manual stabilization only (14.1 ±20.9 vs. 18.9±29.0; p = 0.081). Conclusion : It seems that, removal of the rigid cervical collar during ETI in patients with suspected traumatic spine injury could increase the intubation success rate.

Keywords: ntubation, Intratracheal, Spinal Injuries, Multiple trauma

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Authors: Sharon Diaz Ruiz

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This qualitative study addresses college English instructors’ perceptions of classroom diversity and culturally diverse teaching strategies within the adult English language learning classroom environment. Every year, English college instructors face numerous challenges as the adult Latinx population keeps rising. To better understand the Latinx adult learners and the language classroom dynamics, research should focus on the experiences, pedagogical methods, and teaching insights of full-time and adjunct minority professors at degree-granting postsecondary institutions. Culturally responsive teaching is used as the framework to understand and explore the perceptions of English instructors on the realities and needs of Latinx adult emergent bilinguals enrolled in developmental English courses. Snowball sampling allows the researcher to locate members who meet these specific criteria: adjunct and part-time English instructors of adult Latinx language learners. Participants answered a demographic questionnaire and then contributed to 45-minute in-depth interviews to explore their perceptions of culturally responsive practices in the Latinx adult emergent bilinguals’ basic and intermediate developmental English courses. The interviews shed light on topics such as teaching biases, educators’ cultural experiences, and resources and strategies faculty recommend for effective culturally responsive teaching strategies. The result of this investigation will shed light on the gap in the literature documenting the application of culturally responsive pedagogy to Latino adult language learners.

Keywords: Latinx, English language learners, English faculty, adult learners, critical theory, culturally responsive theory

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Authors: Onur Arugaslan, Ajay Samant, Devrim Yaman

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Financial advisors and investors seek new assets which could potentially increase portfolio returns and decrease portfolio risk. Cryptocurrencies represent a relatively new asset class which could serve in both these roles. There has been very little research done in the area of the risk/return tradeoff in a portfolio consisting of fixed income assets, stocks, and cryptocurrency. The objective of this study is a rigorous examination of this issue. The data used in the study are the monthly returns on 4-week US Treasury Bills, S&P Investment Grade Corporate Bond Index, Bitcoin and the S&P 500 Stock Index. The methodology used in the study is the application Modern Portfolio Theory to evaluate the risk-adjusted returns of portfolios with varying combinations of these assets, using Sharpe, Treynor and Jensen Indexes, as well as the Sortino and Modigliani measures. The results of the study would include the ranking of various investment portfolios based on their risk/return characteristics. The conclusions of the study would include objective empirical inference for investors who are interested in including cryptocurrency in their asset portfolios but are unsure of the risk/return implications.

Keywords: financial economics, portfolio diversification, fixed income securities, cryptocurrency, stock indexes

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Authors: Aferdita Dinaku, Jonida Canaj

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Aflatoxins are potentially toxic metabolites produced by certain kinds of fungi (molds) that are found naturally all over the world; they can contaminate food crops and pose a serious health threat to humans by mutagenic and carcinogenic effects. Several types of aflatoxin (14 or more) occur in nature. In Albanian nutrition, cereals (especially wheat and corn) are common ingredients in some traditional meals. This study aimed to investigate the presence of aflatoxins in the flour of wheat and maize that are consumed in Albania’s markets. The samples were collected randomly in different markets in Albania and detected by the ELISA method, measured in 450 nm. The concentration of total aflatoxins was analyzed by enzyme-linked immunosorbent assay (ELISA), and they were ranged between 0.05-1.09 ppb. However, the screened mycotoxin levels in the samples were lower than the maximum permissible limits of European Commission No 1881/2006 (4 μg/kg). The linearity of calibration curves was good for total aflatoxins (B1, B2, G1, G2, M1) (R²=0.99) in the concentration range 0.005-4.05 ppb. The samples were analyzed in two replicated measurements and for each sample, the standard deviation (statistical parameter) is calculated. The results showed that the flour samples are safe, but the necessity of performing such tests is necessary.

Keywords: aflatoxins, ELISA technique, food contamination, flour

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Authors: Andrew Nowlan

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During the Coronavirus pandemic, collaborative online international learning (COIL) emerged as an alternative to overseas sojourns. However, now that face-to-face classes have resumed and students are studying abroad, the rationale for doing COIL is not always clear amongst educators and students. Also, the logistics of COIL become increasingly complicated when participants involved in a potential collaboration have different second language (L2) learning goals. In this paper, the researcher will report on a study involving two bilingual, cross-cultural COIL courses between students at a university in Japan and those studying in North America, from April to December, 2022. The students in Japan were enrolled in an intercultural communication class in their L2 of English, while the students in Canada and the United States were studying intermediate Japanese as their L2. Based on a qualitative survey and journaling data received from 31 students in Japan, and employing a transcendental phenomenological research design, the researcher will highlight the students’ essence of experience during COIL. Essentially, students benefited from the experience through improved communicative competences and increased knowledge of the target culture, even when the L2 learning goals between institutions differed. Students also reported that the COIL experience was effective in preparation for actual study abroad, as opposed to a replacement for it, which challenges the existing literature. Both educators and administrators will be exposed to the perceptions of Japanese university students towards COIL, which could be generalized to other higher education contexts, including those in Southeast Asia. Readers will also be exposed to ideas for developing more effective pre-departure study abroad programs and domestic intercultural curriculum through COIL, even when L2 learning goals may differ between participants.

Keywords: collaborative online international learning, study abroad, phenomenology, EdTech, intercultural communication

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Authors: Mauro Masili, Liliane Ventura

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It is still controversial in the literature the ultraviolet (UV) radiation effects on the ocular media, but the World Health Organization has established safe limits on the exposure of eyes to UV radiation based on reports in literature. Sunglasses play an important role in providing safety, and their lenses should provide adequate UV filters. Regarding UV protection for ocular media, the resistance-to-irradiance test for sunglasses under many national standards requires irradiating lenses for 50 uninterrupted hours with a 450 W solar simulator. This artificial aging test may provide a corresponding evaluation of exposure to the sun. Calculating the direct and diffuse solar irradiance at a vertical surface and the corresponding radiant exposure for the entire year, we compare the latter with the 50-hour radiant exposure of a 450 W xenon arc lamp from a solar simulator required by national standards. Our calculations indicate that this stress test is ineffective in its present form. We provide evidence of the need to re-evaluate the parameters of the tests to establish appropriate safe limits against UV radiation. This work is potentially significant for scientists and legislators in the field of sunglasses standards to improve the requirements of sunglasses quality and safety.

Keywords: ISO 12312-1, solar simulator, sunglasses standards, UV protection

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Authors: Neda Menbari, Ramin Mehdiabadi

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Background: breast cancer remains a critical global health issue, constituting a leading cause of cancer-related mortality in women. MicroRNAs (miRs) are natural RNA molecules that play an important role in cellular processes and regulate post-transcriptional gene expression. MiR-216b-5p is a miR that acts as a tumor suppressor. The expression levels of FoxM1 and miR-216b-5p in malignant and control cells have been evaluated by quantitative polymerase chain reaction (qPCR) technique and flow cytometry. Results: the results of this study revealed a significant downregulation of miR-216b-5p in cancerous cells compared to the control MCF-10A cells (P=0.0004). Interestingly, the expression of miR-216b-5p exhibited an inverse relationship with key clinical indicators such as tumor size, grade, and lymph node invasion. Conclusion: The study's findings showed the prognostic value of miR-216b-5p levels in breast cancer, and its reduced expression correlates with unfavorable tumor characteristics. This research recommends performing more studies on the role of FoxM1 and miR-216b-5p in breast cancer pathology which potentially paving the way for targeted therapeutic interventions.

Keywords: breast cancer, gene expression, FOXM1, microRNA

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