Search results for: communication controlled protection
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8539

Search results for: communication controlled protection

1819 Distributed Coordination of Connected and Automated Vehicles at Multiple Interconnected Intersections

Authors: Zhiyuan Du, Baisravan Hom Chaudhuri, Pierluigi Pisu

Abstract:

In connected vehicle systems where wireless communication is available among the involved vehicles and intersection controllers, it is possible to design an intersection coordination strategy that leads the connected and automated vehicles (CAVs) travel through the road intersections without the conventional traffic light control. In this paper, we present a distributed coordination strategy for the CAVs at multiple interconnected intersections that aims at improving system fuel efficiency and system mobility. We present a distributed control solution where in the higher level, the intersection controllers calculate the road desired average velocity and optimally assign reference velocities of each vehicle. In the lower level, every vehicle is considered to use model predictive control (MPC) to track their reference velocity obtained from the higher level controller. The proposed method has been implemented on a simulation-based case with two-interconnected intersection network. Additionally, the effects of mixed vehicle types on the coordination strategy has been explored. Simulation results indicate the improvement on vehicle fuel efficiency and traffic mobility of the proposed method.

Keywords: connected vehicles, automated vehicles, intersection coordination systems, multiple interconnected intersections, model predictive control

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1818 Characteristics of Business Models of Industrial-Internet-of-Things Platforms

Authors: Peter Kress, Alexander Pflaum, Ulrich Loewen

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The number of Internet-of-Things (IoT) platforms is steadily increasing across various industries, especially for smart factories, smart homes and smart mobility. Also in the manufacturing industry, the number of Industrial-IoT platforms is growing. Both IT players, start-ups and increasingly also established industry players and small-and-medium-enterprises introduce offerings for the connection of industrial equipment on platforms, enabled by advanced information and communication technology. Beside the offered functionalities, the established ecosystem of partners around a platform is one of the key differentiators to generate a competitive advantage. The key question is how platform operators design the business model around their platform to attract a high number of customers and partners to co-create value for the entire ecosystem. The present research tries to answer this question by determining the key characteristics of business models of successful platforms in the manufacturing industry. To achieve that, the authors selected an explorative qualitative research approach and created an inductive comparative case study. The authors generated valuable descriptive insights of the business model elements (e.g., value proposition, pricing model or partnering model) of various established platforms. Furthermore, patterns across the various cases were identified to derive propositions for the successful design of business models of platforms in the manufacturing industry.

Keywords: industrial-internet-of-things, business models, platforms, ecosystems, case study

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1817 Challenges and Prospects of Digital Economy Development in Georgia

Authors: Gulnaz Erkomaishvili

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Introduction: There are some of the biggest technological shifts happening in the modern world. The introduction of digital technologies, information, and communication services has given rise to unprecedented global socio-political and economic changes. The role of digital technologies in increasing productivity and national competitiveness is increasing. Today, it is used in almost every area of the economy. E-commerce, organizational process in computerized management, and digital infrastructure's pace of growth is remarkably high and is a key instrument of economic development. Methodology: Different research methods are applied in the presented paper; statistical, analysis, synthesis, induction, deduction, comparison ones. Works by local and foreign scientists, Ministry of Economy and Sustainable Development, as well as various organizations' studies and reports were used as a theoretical basis for research and variety of laws, government decrees and orders, and the publications of the National Statistics Office of Georgia were used as an informational basis. Conclusions: The paper deals with the processes and challenges in Georgia in the digital economy. Access to current resources in Georgia and current processes are described. Digital technology for the development of the required environmental conditions is described, how the Internet and communications are available for the population in the regions of Georgia. The pros and cons of the digital economy development and its impact on the country's economy are analyzed. The main difficulties of implementation of the digital economy in Georgia, government involvement, and future action plans are presented.

Keywords: digital economy, digital technologies, internet, communications, economic policy

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1816 Comparison Between Bispectral Index Guided Anesthesia and Standard Anesthesia Care in Middle Age Adult Patients Undergoing Modified Radical Mastectomy

Authors: Itee Chowdhury, Shikha Modi

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Introduction: Cancer is beginning to outpace cardiovascular disease as a cause of death affecting every major organ system with profound implications for perioperative management. Breast cancer is the most common cancer in women in India, accounting for 27% of all cancers. The small changes in analgesic management of cancer patients can greatly improve prognosis and reduce the risk of postsurgical cancer recurrence as opioid-based analgesia has a deleterious effect on cancer outcomes. Shortened postsurgical recovery time facilitates earlier return to intended oncological therapy maximising the chance of successful treatment. Literature reveals that the role of BIS since FDA approval has been assessed in various types of surgeries, but clinical data on its use in oncosurgical patients are scanty. Our study focuses on the role of BIS-guided anaesthesia for breast cancer surgery patients. Methods: A prospective randomized controlled study in patients aged 36-55years scheduled for modified radical mastectomy was conducted in 51 patients in each group who met the inclusion and exclusion criteria, and randomization was done by sealed envelope technique. In BIS guided anaesthesia group (B), sevoflurane was titrated to keep the BIS value 45-60, and thereafter if the patient showed hypertension/tachycardia, an opioid was given. In standard anaesthesia care (group C), sevoflurane was titrated to keep MAC in the range of 0.8-1, and fentanyl was given if the patient showed hypertension/tachycardia. Intraoperative opioid consumption was calculated. Postsurgery recovery characteristics, including Aldrete score, were assessed. Patients were questioned for pain, PONV, and recall of the intraoperative event. A comparison of age, BMI, ASA, recovery characteristics, opioid, and VAS score was made using the non-parametric Mann-Whitney U test. Categorical data like intraoperative awareness of surgery and PONV was studied using the Chi-square test. A comparison of heart rate and MAP was made by an independent sample t-test. #ggplot2 package was used to show the trend of the BIS index for all intraoperative time points for each patient. For a statistical test of significance, the cut-off p-value was set as <0.05. Conclusions: BIS monitoring led to reduced opioid consumption and early recovery from anaesthesia in breast cancer patients undergoing MRM resulting in less postoperative nausea and vomiting and less pain intensity in the immediate postoperative period without any recall of the intraoperative event. Thus, the use of a Bispectral index monitor allows for tailoring of anaesthesia administration with a good outcome.

Keywords: bispectral index, depth of anaesthesia, recovery, opioid consumption

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1815 Transforming Emergency Care: Revolutionizing Obstetrics and Gynecology Operations for Enhanced Excellence

Authors: Lolwa Alansari, Hanen Mrabet, Kholoud Khaled, Abdelhamid Azhaghdani, Sufia Athar, Aska Kaima, Zaineb Mhamdia, Zubaria Altaf, Almunzer Zakaria, Tamara Alshadafat

Abstract:

Introduction: The Obstetrics and Gynecology Emergency Department at Alwakra Hospital has faced significant challenges, which have been further worsened by the impact of the COVID-19 pandemic. These challenges involve issues such as overcrowding, extended wait times, and a notable surge in demand for emergency care services. Moreover, prolonged waiting times have emerged as a primary factor contributing to situations where patients leave without receiving attention, known as left without being seen (LWBS), and unexpectedly abscond. Addressing the issue of insufficient patient mobility in the obstetrics and gynecology emergency department has brought about substantial improvements in patient care, healthcare administration, and overall departmental efficiency. These changes have not only alleviated overcrowding but have also elevated the quality of emergency care, resulting in higher patient satisfaction, better outcomes, and operational rewards. Methodology: The COVID-19 pandemic has served as a catalyst for substantial transformations in the obstetrics and gynecology emergency, aligning seamlessly with the strategic direction of Hamad Medical Corporation (HMC). The fundamental aim of this initiative is to revolutionize the operational efficiency of the OB-GYN ED. To accomplish this mission, a range of transformations has been initiated, focusing on essential areas such as digitizing systems, optimizing resource allocation, enhancing budget efficiency, and reducing overall costs. The project utilized the Plan-Do-Study-Act (PDSA) model, involving a diverse team collecting baseline data and introducing throughput improvements. Post-implementation data and feedback were analysed, leading to the integration of effective interventions into standard procedures. These interventions included optimized space utilization, real-time communication, bedside registration, technology integration, pre-triage screening, enhanced communication and patient education, consultant presence, and a culture of continuous improvement. These strategies significantly reduced waiting times, enhancing both patient care and operational efficiency. Results: Results demonstrated a substantial reduction in overall average waiting time, dropping from 35 to approximately 14 minutes by August 2023. The wait times for priority 1 cases have been reduced from 22 to 0 minutes, and for priority 2 cases, the wait times have been reduced from 32 to approximately 13.6 minutes. The proportion of patients spending less than 8 hours in the OB ED observation beds rose from 74% in January 2022 to over 98% in 2023. Notably, there was a remarkable decrease in LWBS and absconded patient rates from 2020 to 2023. Conclusion: The project initiated a profound change in the department's operational environment. Efficiency became deeply embedded in the unit's culture, promoting teamwork among staff that went beyond the project's original focus and had a positive influence on operations in other departments. This effectiveness not only made processes more efficient but also resulted in significant cost reductions for the hospital. These cost savings were achieved by reducing wait times, which in turn led to fewer prolonged patient stays and reduced the need for additional treatments. These continuous improvement initiatives have now become an integral part of the Obstetrics and Gynecology Division's standard operating procedures, ensuring that the positive changes brought about by the project persist and evolve over time.

Keywords: overcrowding, waiting time, person centered care, quality initiatives

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1814 Funding Innovative Activities in Firms: The Ownership Structure and Governance Linkage - Evidence from Mongolia

Authors: Ernest Nweke, Enkhtuya Bavuudorj

Abstract:

The harsh realities of the scandalous failure of several notable corporations in the past two decades have inextricably resulted in a surge in corporate governance studies. Nevertheless, little or no attention has been paid to corporate governance studies in Mongolian firms and much less to the comprehension of the correlation among ownership structure, corporate governance mechanisms and trend of innovative activities. Innovation is the bed rock of enterprise success. However, the funding and support for innovative activities in many firms are to a great extent determined by the incentives provided by the firm’s internal and external governance mechanisms. Mongolia is an East Asian country currently undergoing a fast-paced transition from socialist to democratic system and it is a widely held view that private ownership as against public ownership fosters innovation. Hence, following the privatization policy of Mongolian Government which has led to the transfer of the ownership of hitherto state controlled and state directed firms to private individuals and organizations, expectations are high that sufficient motivation would be provided for firm managers to engage in innovative activities. This research focuses on the relationship between ownership structure, corporate governance on one hand and the level of innovation on the hand. The paper is empirical in nature and derives data from both reliable secondary and primary sources. Secondary data for the study was in respect of ownership structure of Mongolian listed firms and innovation trend in Mongolia generally. These were analyzed using tables, charts, bars and percentages. Personal interviews and surveys were held to collect primary data. Primary data was in respect of corporate governance practices in Mongolian firms and were collected using structured questionnaire. Out of a population of three hundred and twenty (320) companies listed on the Mongolian Stock Exchange (MSE), a sample size of thirty (30) randomly selected companies was utilized for the study. Five (5) management level employees were surveyed in each selected firm giving a total of one hundred and fifty (150) respondents. Data collected were analyzed and research hypotheses tested using Chi-Square test statistic. Research results showed that corporate governance mechanisms were better and have significantly improved overtime in privately held as opposed to publicly owned firms. Consequently, the levels of innovation in privately held firms were considerably higher. It was concluded that a significant and positive relationship exists between private ownership and good corporate governance on one hand and the level of funding provided for innovative activities in Mongolian firms on the other hand.

Keywords: corporate governance, innovation, ownership structure, stock exchange

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1813 Effect of Internet Addiction on Dietary Behavior and Lifestyle Characteristics among University Students

Authors: Hafsa Kamran, Asma Afreen, Zaheer Ahmed

Abstract:

Internet addiction, an emerging mental health disorder from last two decades, is manifested by the inability in the controlled use of internet leading to academics, social, physiological and/or psychological difficulties. The present study aimed to assess the levels of internet addiction among university students in Lahore and to explore the effects of internet addiction on their dietary behavior and lifestyle. It was an analytical cross-sectional study. Data was collected from October to December 2016 from students of four universities selected through two-stage sampling method. The numbers of participants were 500 and 13 questionnaires were rejected due to incomplete information. Levels of Internet Addiction (IA) were calculated using Young Internet Addiction Test (YIAT). Data was also collected on students’ demographics, lifestyle factors and dietary behavior using self-reported questionnaire. Data was analyzed using SPSS (version 21). Chi-square test was applied to evaluate the relationship between variables. Results of the study revealed that 10% of the population had severe internet addiction while moderate Internet Addiction was present in 42%. High prevalence was found among males (11% vs. 8%), private sector university students (p = 0.008) and engineering students (p = 0.000). The lifestyle habits of internet addicts were significantly of poorer quality than normal users (p = 0.05). Internet addiction was found associated with lesser physically activity (p = 0.025), had shorter duration of physical activity (p = 0.016), had more disorganized sleep pattern (p = 0.023), had less duration of sleep (p = 0.019), reported being more tired and sleepy in class (p = 0.033) and spending more time on internet as compared to normal users. Severe and moderate internet addicts also found to be more overweight and obese than normal users (p = 0.000). The dietary behavior of internet addicts was significantly poorer than normal users. Internet addicts were found to skip breakfast more than a normal user (p = 0.039). Common reasons for meal skipping were lack of time and snacking between meals (p = 0.000). They also had increased meal size (p = 0.05) and habit of snacking while using the internet (p = 0.027). Fast food (p = 0.016) and fried items (p = 0.05) were most consumed snacks, while carbonated beverages (p = 0.019) were most consumed beverages among internet addicts. Internet Addicts were found to consume less than recommended daily servings of dairy (p = 0.008) and fruits (p = 0.000) and more servings of meat group (p = 0.025) than their no internet addict counterparts. In conclusion, in this study, it was demonstrated that internet addicts have unhealthy dietary behavior and inappropriate lifestyle habits. University students should be educated regarding the importance of balanced diet and healthy lifestyle, which are critical for effectual primary prevention of numerous chronic degenerative diseases. Furthermore, it is necessary to raise awareness concerning adverse effects of internet addiction among youth and their parents.

Keywords: dietary behavior, internet addiction, lifestyle, university students

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1812 A Pragma-Rhetorical Study of Christian Religious Pentecostal Sermons in Nigeria

Authors: Samuel Alaba Akinwotu

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Effectiveness in communication requires the deployment of pragmatic and rhetorical strategies in religious sermons. In spite of high volume of works in religious discourse, scholars have not adequately accounted for the persuasive and argumentation strategies employed in Christian religious Pentecostal sermons. This study examines communicative intentions and the pragma-rhetorical strategies deployed to maintain balance and effectiveness in selected sermons of Pastor E. A. Adeboye, Bishop D. Oyedepo and Pastor W. F. Kumuyi. Fifteen sermons, delivered orally and transcribed into the written mode, were selected and analysed using Jacob Mey’s theory of pragmeme, Aristotle’s rhetoric and the theory of argumentation by van Eemeren and Grootendorst. Speakers pract stating, encouraging, assuring, warning, condemning, directing, praising, thanking, etc. through rhetorical question, repetition, direct address, direct command and structural parallelism. They assume divine role by speaking authoritatively and they tactically and logically select words to legitimise their ideology. They also categorise and portray individuals and/or issues either as good or bad, sinner/sin or righteous/righteousness, etc. The study provides clearer insight into the pragmatic import and the communicative effectiveness of Christian Pentecostal sermons. Further research can juxtapose the pragma-rhetorical and argumentation strategies of preachers of two clearly differentiated movements within the Christian religion.

Keywords: argumentation, communicative intentions, pentecostal sermons, pragmeme, rhetoric

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1811 Assessment of the Efficacy of Routine Medical Tests in Screening Medical Radiation Staff in Shiraz University of Medical Sciences Educational Centers

Authors: Z. Razi, S. M. J. Mortazavi, N. Shokrpour, Z. Shayan, F. Amiri

Abstract:

Long-term exposure to low doses of ionizing radiation occurs in radiation health care workplaces. Although doses in health professions are generally very low, there are still matters of concern. The radiation safety program promotes occupational radiation safety through accurate and reliable monitoring of radiation workers in order to effectively manage radiation protection. To achieve this goal, it has become mandatory to implement health examination periodically. As a result, based on the hematological alterations, working populations with a common occupational radiation history are screened. This paper calls into question the effectiveness of blood component analysis as a screening program which is mandatory for medical radiation workers in some countries. This study details the distribution and trends of changes in blood components, including white blood cells (WBCs), red blood cells (RBCs) and platelets as well as received cumulative doses from occupational radiation exposure. This study was conducted among 199 participants and 100 control subjects at the medical imaging departments at the central hospital of Shiraz University of Medical Sciences during the years 2006–2010. Descriptive and analytical statistics, considering the P-value<0.05 as statistically significance was used for data analysis. The results of this study show that there is no significant difference between the radiation workers and controls regarding WBCs and platelet count during 4 years. Also, we have found no statistically significant difference between the two groups with respect to RBCs. Besides, no statistically significant difference was observed with respect to RBCs with regards to gender, which has been analyzed separately because of the lower reference range for normal RBCs levels in women compared to men and. Moreover, the findings confirm that in a separate evaluation between WBCs count and the personnel’s working experience and their annual exposure dose, results showed no linear correlation between the three variables. Since the hematological findings were within the range of control levels, it can be concluded that the radiation dosage (which was not more than 7.58 mSv in this study) had been too small to stimulate any quantifiable change in medical radiation worker’s blood count. Thus, use of more accurate method for screening program based on the working profile of the radiation workers and their accumulated dose is suggested. In addition, complexity of radiation-induced functions and the influence of various factors on blood count alteration should be taken into account.

Keywords: blood cell count, mandatory testing, occupational exposure, radiation

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1810 Analysis of Fuel Adulteration Consequences in Bangladesh

Authors: Mahadehe Hassan

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In most countries manufacturing, trading and distribution of gasoline and diesel fuels belongs to the most important sectors of national economy. For Bangladesh, a robust, well-functioning, secure and smartly managed national fuel distribution chain is an essential precondition for achieving Government top priorities in development and modernization of transportation infrastructure, protection of national environment and population health as well as, very importantly, securing due tax revenue for the State Budget. Bangladesh is a developing country with complex fuel supply network, high fuel taxes incidence and – till now - limited possibilities in application of modern, automated technologies for Government national fuel market control. Such environment allows dishonest physical and legal persons and organized criminals to build and profit from illegal fuel distribution schemes and fuel illicit trade. As a result, the market transparency and the country attractiveness for foreign investments, law-abiding economic operators, national consumers, State Budget and the Government ability to finance development projects, and the country at large suffer significantly. Research shows that over 50% of retail petrol stations in major agglomerations of Bangladesh sell adulterated fuels and/or cheat customers on the real volume of the fuel pumped into their vehicles. Other forms of detected fuel illicit trade practices include misdeclaration of fuel quantitative and qualitative parameters during internal transit and selling of non-declared and smuggled fuels. The aim of the study is to recommend the implementation of a National Fuel Distribution Integrity Program (FDIP) in Bangladesh to address and resolve fuel adulteration and illicit trade problems. The program should be customized according to the specific needs of the country and implemented in partnership with providers of advanced technologies. FDIP should enable and further enhance capacity of respective Bangladesh Government authorities in identification and elimination of all forms of fuel illicit trade swiftly and resolutely. FDIP high-technology, IT and automation systems and secure infrastructures should be aimed at the following areas (1) fuel adulteration, misdeclaration and non-declaration; (2) fuel quality and; (3) fuel volume manipulation at retail level. Furthermore, overall concept of FDIP delivery and its interaction with the reporting and management systems used by the Government shall be aligned with and support objectives of the Vision 2041 and Smart Bangladesh Government programs.

Keywords: fuel adulteration, octane, kerosene, diesel, petrol, pollution, carbon emissions

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1809 Glycan Analyzer: Software to Annotate Glycan Structures from Exoglycosidase Experiments

Authors: Ian Walsh, Terry Nguyen-Khuong, Christopher H. Taron, Pauline M. Rudd

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Glycoproteins and their covalently bonded glycans play critical roles in the immune system, cell communication, disease and disease prognosis. Ultra performance liquid chromatography (UPLC) coupled with mass spectrometry is conventionally used to qualitatively and quantitatively characterise glycan structures in a given sample. Exoglycosidases are enzymes that catalyze sequential removal of monosaccharides from the non-reducing end of glycans. They naturally have specificity for a particular type of sugar, its stereochemistry (α or β anomer) and its position of attachment to an adjacent sugar on the glycan. Thus, monitoring the peak movements (both in the UPLC and MS1) after application of exoglycosidases provides a unique and effective way to annotate sugars with high detail - i.e. differentiating positional and linkage isomers. Manual annotation of an exoglycosidase experiment is difficult and time consuming. As such, with increasing sample complexity and the number of exoglycosidases, the analysis could result in manually interpreting hundreds of peak movements. Recently, we have implemented pattern recognition software for automated interpretation of UPLC-MS1 exoglycosidase digestions. In this work, we explain the software, indicate how much time it will save and provide example usage showing the annotation of positional and linkage isomers in Immunoglobulin G, apolipoprotein J, and simple glycan standards.

Keywords: bioinformatics, automated glycan assignment, liquid chromatography, mass spectrometry

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1808 Development and Evaluation of a Gut-Brain Axis Chip Based on 3D Printing Interconnecting Microchannel Scaffolds

Authors: Zhuohan Li, Jing Yang, Yaoyuan Cui

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The gut-brain axis (GBA), a communication network between gut microbiota and the brain, benefits for investigation of brain diseases. Currently, organ chips are considered one of the potential tools for GBA research. However, most of the available GBA chips have limitations in replicating the three-dimensional (3D) growth environment of cells and lack the required cell types for barrier function. In the present study, a microfluidic chip was developed for GBA interaction. Blood-brain barrier (BBB) module was prepared with HBMEC, HBVP, U87 cells and decellularized matrix (dECM). Intestinal epithelial barrier (IEB) was prepared with Caco-2 and vascular endothelial cells and dECM. GBA microfluidic device was integrated with IEB and BBB modules using 3D printing interconnecting microchannel scaffolds. BBB and IEB interaction on this GBA chip were evaluated with lipopolysaccharide (LPS) exposure. The present GBA chip achieved multicellular three-dimensional cultivation. Compared with the co-culture cell model in the transwell, fluorescein was absorbed more slowly by 5.16-fold (IEB module) and 4.69-fold (BBB module) on the GBA chip. Accumulation of Rhodamine 123 and Hoechst33342 was dramatically decreased. The efflux function of transporters on IEB and BBB was significantly increased on the GBA chip. After lipopolysaccharide (LPS) disrupted the IEB, and then BBB dysfunction was further observed, which confirmed the interaction between IEB and BBB modules. These results demonstrated that this GBA chip may offer a promising tool for gut-brain interaction study.

Keywords: decellularized matrix, gut-brain axis, organ-on-chip, three-dimensional printing.

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1807 Identifying Autism Spectrum Disorder Using Optimization-Based Clustering

Authors: Sharifah Mousli, Sona Taheri, Jiayuan He

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Autism spectrum disorder (ASD) is a complex developmental condition involving persistent difficulties with social communication, restricted interests, and repetitive behavior. The challenges associated with ASD can interfere with an affected individual’s ability to function in social, academic, and employment settings. Although there is no effective medication known to treat ASD, to our best knowledge, early intervention can significantly improve an affected individual’s overall development. Hence, an accurate diagnosis of ASD at an early phase is essential. The use of machine learning approaches improves and speeds up the diagnosis of ASD. In this paper, we focus on the application of unsupervised clustering methods in ASD as a large volume of ASD data generated through hospitals, therapy centers, and mobile applications has no pre-existing labels. We conduct a comparative analysis using seven clustering approaches such as K-means, agglomerative hierarchical, model-based, fuzzy-C-means, affinity propagation, self organizing maps, linear vector quantisation – as well as the recently developed optimization-based clustering (COMSEP-Clust) approach. We evaluate the performances of the clustering methods extensively on real-world ASD datasets encompassing different age groups: toddlers, children, adolescents, and adults. Our experimental results suggest that the COMSEP-Clust approach outperforms the other seven methods in recognizing ASD with well-separated clusters.

Keywords: autism spectrum disorder, clustering, optimization, unsupervised machine learning

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1806 The Politics of Cinema: Representation of Rising Nationalism in Indian Cinema in the Election Year of 2019

Authors: Paawani Tewari, Oishik Dasgupta

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Cinema and politics have often intertwined in India. Movies have become a mainstream method of communication with audiences and voters subliminally and directly. Indian film industry on average produces over a thousand films in a year, and during the election year of 2019, India witnessed the release of several highly political movies. Movies such as Uri: The Surgical Strike, Accidental Prime Minister, and PM Modi, et cetera, which are the sample of this study have tried to depict an ideal character of political stalwart leaders with the plausibility to inspire and aiming to change ideological orientations of viewers and the potent voters. This study tries to understand the major links between nationalism, its representation, and its manifestation in Indian cinema and how it is instrumental in shaping the character and orientations of its citizens towards nation, nationalism, and nationhood. Our work aims to highlight how nationalistic assumptions that are swaddled in the Hindi movies released during January 2019 – May 2019 affect the political mood of the nation and, in totality, the democratic system. The authors also try to throw light on how films being a powerful tool, are now being used to shape ideas, brainwashing and swaying opinions for political mileage. Hence it becomes essential for us to explore the dynamics between the quintessential definitions of what nationalism is for a common man in India versus of what has been represented in cinema, especially during the time of the elections.

Keywords: political governance and political analysis, political and public administration, election, public choice

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1805 Exploration of Bullying Perceptions in Adolescents in Sekolah Menengah Kejuruan Negeri 1 Manado

Authors: Madjid Nancy, Rakinaung Natalia, Lumowa Fresy

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Background: Bullying becomes one of the problems that concern the world of education, especially in adolescents, which has a negative impact on learning achievement, psychology, and physical health. The psychological impact is shame, depression, distress, fear, sadness, and anxiety, so that if prolonged leave can lead to depression in the victim. While the impact on physical health in the form of bruises on the hit area, blisters, swelling and in more severe cases will lead to death. Objectives: This study aims to explore the perception of bullying in adolescent students Sekolah Menengah Kejuruan (SMK) Negeri 1 Manado and the people associated with that adolescent students. Methods: This research uses descriptive qualitative research design and using thematic analysis, and supported by Urie Bronfenbrenner Ecological Framework. The data collection that will be used is by in-depth interview. Sampling using purposive sampling and snowball techniques. This research was conducted at SMK Negeri 1 Manado. Result: From the analysis obtained three themes with the categories: 1) the perception of bullying with categories are: Understanding of Bullying and The Impact of Bullying, 2) the originator of bullying with categories are: Fulfillment of Youth Development Tasks and Needs, Peers Influence, and Family Communication; 3) the effort to handle bullying with categories are: the Individual Coping and Teacher Role. Conclusion: This research get three themes, those are perception of bullying, bullying’s originator and the effort of handling bullying.

Keywords: adolscent, students, bullying, perception

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1804 Thermal Comfort and Outdoor Urban Spaces in the Hot Dry City of Damascus, Syria

Authors: Lujain Khraiba

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Recently, there is a broad recognition that micro-climate conditions contribute to the quality of life in urban spaces outdoors, both from economical and social viewpoints. The consideration of urban micro-climate and outdoor thermal comfort in urban design and planning processes has become one of the important aspects in current related studies. However, these aspects are so far not considered in urban planning regulations in practice and these regulations are often poorly adapted to the local climate and culture. Therefore, there is a huge need to adapt the existing planning regulations to the local climate especially in cities that have extremely hot weather conditions. The overall aim of this study is to point out the complexity of the relationship between urban planning regulations, urban design, micro-climate and outdoor thermal comfort in the hot dry city of Damascus, Syria. The main aim is to investigate the temporal and spatial effects of micro-climate on urban surface temperatures and outdoor thermal comfort in different urban design patterns as a result of urban planning regulations during the extreme summer conditions. In addition, studying different alternatives of how to mitigate the surface temperature and thermal stress is also a part of the aim. The novelty of this study is to highlight the combined effect of urban surface materials and vegetation to develop the thermal environment. This study is based on micro-climate simulations using ENVI-met 3.1. The input data is calibrated according to a micro-climate fieldwork that has been conducted in different urban zones in Damascus. Different urban forms and geometries including the old and the modern parts of Damascus are thermally evaluated. The Physiological Equivalent Temperature (PET) index is used as an indicator for outdoor thermal comfort analysis. The study highlights the shortcomings of existing planning regulations in terms of solar protection especially at street levels. The results show that the surface temperatures in Old Damascus are lower than in the modern part. This is basically due to the difference in urban geometries that prevent the solar radiation in Old Damascus to reach the ground and heat up the surface whereas in modern Damascus, the streets are prescribed as wide spaces with high values of Sky View Factor (SVF is about 0.7). Moreover, the canyons in the old part are paved in cobblestones whereas the asphalt is the main material used in the streets of modern Damascus. Furthermore, Old Damascus is less stressful than the modern part (the difference in PET index is about 10 °C). The thermal situation is enhanced when different vegetation are considered (an improvement of 13 °C in the surface temperature is recorded in modern Damascus). The study recommends considering a detailed landscape code at street levels to be integrated in urban regulations of Damascus in order to achieve a better urban development in harmony with micro-climate and comfort. Such strategy will be very useful to decrease the urban warming in the city.

Keywords: micro-climate, outdoor thermal comfort, urban planning regulations, urban spaces

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1803 The Challenges Involved in Investigating and Prosecuting Hate Crime Online

Authors: Mark Williams

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The digital revolution has radically transformed our social environment creating vast opportunities for interconnectivity and social interaction. This revolution, however, has also changed the reach and impact of hate crime, with social media providing a new platform to victimize and harass users in their homes. In this way, developments in the information and communication technologies have exacerbated and facilitated the commission of hate crime, increasing its prevalence and impact. Unfortunately, legislators, policymakers and criminal justice professionals have struggled to keep pace with these technological developments, reducing their ability to intervene in, regulate and govern the commission of hate crimes online. This work is further complicated by the global nature of this crime due to the tendency for offenders and victims to reside in multiple different jurisdictions, as well as the need for criminal justice professionals to obtain the cooperation of private companies to access information required for prosecution. Drawing on in-depth interviews with key criminal justice professionals and policymakers with detailed knowledge in this area, this paper examines the specific challenges the police and prosecution services face as they attempt to intervene in and prosecute the commission of hate crimes online. It is argued that any attempt to reduce online othering, such as the commission of hate crimes online, must be multifaceted, collaborative and involve both innovative technological solutions as well as internationally agreed ethical and legal frameworks.

Keywords: cybercrime, digital policing, hate crime, social media

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1802 The Use of Robots for Children and Young People on the Autism Spectrum: A Systematic Review

Authors: Athanasia Kouroupa

Abstract:

Existing research highlights the effect of employing robots in sessions with children and young people on the autism spectrum to develop and practice skills important to independent and functional living. The systematic review aimed to explore the way robots has been used with children and young people on the autism spectrum and the effect of using robots as a therapeutic interface. An electronic bibliographic database search using a combination of expressions was conducted. Data were extracted in relation to robot types, session characteristics, and outcomes and analysed using narrative synthesis. Forty studies were selected in the review. Humanoid robots were predominantly used to practice a range of social and communication skills. On average, children and young people on the autism spectrum had five sessions, twice a week, for approximately half an hour. Having sessions with a robot was commonly equal to or more effective than 'traditional' interventions delivered by a human therapist or having no therapy. The review reported encouraging outcomes to practice and develop a range of skills with children and young people on the autism spectrum. These findings suggest that some form of intervention is favourable over no intervention. However, there is little evidence for the relative effectiveness of the robot-based intervention as an innovative alternative option. Many of the studies had methodological weaknesses that make them vulnerable to bias. There is a need for further research that adheres to strict scientific methods making direct comparisons between different treatment options.

Keywords: autism, children, robots, outcomes

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1801 Observing Upin and Ipin Animation Roles in Early Childhood Education

Authors: Juhanita Jiman

Abstract:

Malaysia is a unique country with multifaceted society; rich with its beautiful cultural values. It has been a long assimilation process for Malaysia to emerge its national identity. Malaysian government has been working hard for centuries to keep its people together in harmony. Cultural identity is identified to be ‘container’ that brings Malaysians together. The uniqueness of Malaysian cultures can actually be exploited for the benefit of the nation. However, this unique culture is somehow being threatened by those imported foreign values. If not closely monitored, these foreign influences can bring more damages than good. This paper aims to study elements in Upin and Ipin animation series and investigate how this series could help to educate local children with good moral and behaviour without being too serious and sententious. Upin and Ipin is chosen as a study to investigate the effectiveness of animation as a media of communication to promote positive values amongst pre-school children. Purposive sampling method was employed to determine the sample of studies hence pre-school children from Putrajaya Presint 9(2) school were chosen to take part in this study. The findings of this study demonstrate positive suggestions on how animation programmes being shown on TV can play significant roles in children social development and inculcate good moral behaviour as well as social skills among children and people around them.

Keywords: animation characters, children informal education, foreign influences, moral values

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1800 Space Debris Mitigation: Solutions from the Dark Skies of the Remote Australian Outback Using a Proposed Network of Mobile Astronomical Observatories

Authors: Muhammad Akbar Hussain, Muhammad Mehdi Hussain, Waqar Haider

Abstract:

There are tens of thousands of undetected and uncatalogued pieces of space debris in the Low Earth Orbit (LEO). They are not only difficult to be detected and tracked, their sheer number puts active satellites and humans in orbit around Earth into danger. With the entry of more governments and private companies into harnessing the Earth’s orbit for communication, research and military purposes, there is an ever-increasing need for not only the detection and cataloguing of these pieces of space debris, it is time to take measures to take them out and clean up the space around Earth. Current optical and radar-based Space Situational Awareness initiatives are useful mostly in detecting and cataloguing larger pieces of debris mainly for avoidance measures. Smaller than 10 cm pieces are in a relatively dark zone, yet these are deadly and capable of destroying satellites and human missions. A network of mobile observatories, connected to each other in real time and working in unison as a single instrument, may be able to detect small pieces of debris and achieve effective triangulation to help create a comprehensive database of their trajectories and parameters to the highest level of precision. This data may enable ground-based laser systems to help deorbit individual debris. Such a network of observatories can join current efforts in detection and removal of space debris in Earth’s orbit.

Keywords: space debris, low earth orbit, mobile observatories, triangulation, seamless operability

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1799 Teachers' Learning Community and Their Self Efficacy

Authors: Noha Desouky Aly, Maged Makram Habib

Abstract:

Given the imperative role educational institutions have in the creation of a motivational learning community that develops and engages their students, the influence of evoking the same environment for their teachers needs to be examined. Teachers and their role lie at the core of the efficiency of the learning experience. One exigent aspect in the process of providing professional development to teachers is to involve them in this process, and the best manner would be through creating a learning community in which they are directly engaged and responsible for their own learning. An educational institution that thinks first of its teachers learning and growth would achieve its goals in providing an effective education for its students. The purpose of this research paper is to examine the effect of engaging teachers in a learning community in which they are responsible for their own learning through conducting and providing the material required for the training on their self efficacy, engagement, and perceived autonomy. The sample includes twenty instructors at the German University in Cairo teaching Academic skills at the Department of English and Scientific Methods. The courses taught at the department include Academic skills, writing argumentative essays, critical thinking, communication and presentation skills, and research paper writing. Procedures for the duration of eight weeks will entail pre-post measures to include The Teachers Self Efficacy Scale and an interview. During the weekly departmental meeting, teachers are to share resources and experiences or research and present a topic of their choice that contributes to their professional development. Results are yet to be found.

Keywords: learning community, self- efficacy, teachers, learning experience

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1798 Strategies and Difficulties to Integrate Renewable Energy into Recreational Open Spaces

Authors: A. Tereci, M. Atmaca

Abstract:

Recreational spaces designed or build for refreshment of the users through natural riches and/or activities. Those places contribute to the quality of city life by providing relaxation point for citizens and maintaining the environmental equilibrium. The elements which constitute the recreational areas also promote long-term environmental and social sustainability of cities. Preservation and creation of the recreation open spaces are important for water and air quality, natural habitat and also social communication. On this point, it is also a good area for promoting the renewable energy sources through comprehension of the sustainable development which is possible only with using nature and technic together. Energy production is mainly technical issue, and architectural design of these elements to the site always ignores or avoid. The main problems for integration of renewable energy sources are the system suitability, security, durability, and resiliency. In this paper, one of the city recreational open spaces in Konya, Turkey was evaluated for integration of possible renewable energy sources. It shows that the solar energy potential is high and PV integration is the best option. On the other hand wind, energy power and area is not suitable for wind turbine, so wind belts were decided to integrate on the design. According to recreational activities, the chosen elements was designed for site application, and their performance was calculated. According to possible installation on the furniture, there is 50 MWh/a electricity production capacity.

Keywords: energy, integrated design, recreational space, renewables

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1797 Additive Manufacturing with Ceramic Filler

Authors: Irsa Wolfram, Boruch Lorenz

Abstract:

Innovative solutions with additive manufacturing applying material extrusion for functional parts necessitate innovative filaments with persistent quality. Uniform homogeneity and a consistent dispersion of particles embedded in filaments generally require multiple cycles of extrusion or well-prepared primal matter by injection molding, kneader machines, or mixing equipment. These technologies commit to dedicated equipment that is rarely at the disposal in production laboratories unfamiliar with research in polymer materials. This stands in contrast to laboratories that investigate complex material topics and technology science to leverage the potential of 3-D printing. Consequently, scientific studies in labs are often constrained to compositions and concentrations of fillersofferedfrom the market. Therefore, we introduce a prototypal laboratory methodology scalable to tailoredprimal matter for extruding ceramic composite filaments with fused filament fabrication (FFF) technology. - A desktop single-screw extruder serves as a core device for the experiments. Custom-made filaments encapsulate the ceramic fillers and serve with polylactide (PLA), which is a thermoplastic polyester, as primal matter and is processed in the melting area of the extruder, preserving the defined concentration of the fillers. Validated results demonstrate that this approach enables continuously produced and uniform composite filaments with consistent homogeneity. Itis 3-D printable with controllable dimensions, which is a prerequisite for any scalable application. Additionally, digital microscopy confirms the steady dispersion of the ceramic particles in the composite filament. - This permits a 2D reconstruction of the planar distribution of the embedded ceramic particles in the PLA matrices. The innovation of the introduced method lies in the smart simplicity of preparing the composite primal matter. It circumvents the inconvenience of numerous extrusion operations and expensive laboratory equipment. Nevertheless, it deliversconsistent filaments of controlled, predictable, and reproducible filler concentration, which is the prerequisite for any industrial application. The introduced prototypal laboratory methodology seems capable for other polymer matrices and suitable to further utilitarian particle types beyond and above ceramic fillers. This inaugurates a roadmap for supplementary laboratory development of peculiar composite filaments, providing value for industries and societies. This low-threshold entry of sophisticated preparation of composite filaments - enabling businesses to create their own dedicated filaments - will support the mutual efforts for establishing 3D printing to new functional devices.

Keywords: additive manufacturing, ceramic composites, complex filament, industrial application

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1796 Application of Bacteriophage and Essential Oil to Enhance Photocatalytic Efficiency

Authors: Myriam Ben Said, Dhekra Trabelsi, Faouzi Achouri, Marwa Ben Saad, Latifa Bousselmi, Ahmed Ghrabi

Abstract:

This present study suggests the use of biological and natural bactericide, cheap, safe to handle, natural, environmentally benign agents to enhance the conventional wastewater treatment process. In the same sense, to highlight the enhancement of wastewater photocatalytic treatability, we were used virulent bacteriophage(s) and essential oils (EOs). The pre-phago-treatment of wastewater with lytic phage(s), leads to a decrease in bacterial density and, consequently, limits the establishment of intercellular communication (QS), thus preventing biofilm formation and inhibiting the expression of other virulence factors after photocatalysis. Moreover, to increase the photocatalytic efficiency, we were added to the secondary treated wastewater 1/1000 (w/v) of EO of thyme (T. vulgaris). This EO showed in vitro an anti-biofilm activity through the inhibition of plonctonic cell mobility and their attachment on an inert surface and also the deterioration of the sessile structure. The presence of photoactivatable molecules (photosensitizes) in this type of oil allows the optimization of photocatalytic efficiency without hazards relayed to dyes and chemicals reagent. The use of ‘biological and natural tools’ in combination with usual water treatment process can be considered as a safety procedure to reduce and/or to prevent the recontamination of treated water and also to prevent the re-expression of virulent factors by pathogenic bacteria such as biofilm formation with friendly processes.

Keywords: biofilm, essential oil, optimization, phage, photocatalysis, wastewater

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1795 USA Commercial Pilots’ Views of Crew Resource Management, Social Desirability, and Safety Locus of Control

Authors: Stephen Vera, Tabitha Black, Charalambos Cleanthous, Ryan Sain

Abstract:

A gender comparison of USA commercial pilots’ demographics and views of CRM, social desirability and locus of control were surveyed. The Aviation safety locus of control (ASLOC) was used to measure external (ASLOC-E) or internal (ASLOC-I) aviation safety locus of control. The gender differences were explored using the ASLOC scores as a categorical variable. A differential comparison of crew resource management (CRM), based on the Federal Aviation Administration’s (FAA) guidelines was conducted. The results indicated that the proportion of female to male respondents matches the current ratio of USA commercial pilots. Moreover, there were no significant differences regarding overall education and the total number of communication classes one took. Regarding CRM issues, there were no significant differences on their views regarding the roles of the PIC, stress, time management, and managing a flight team. The females scored significantly lower on aeronautical decision making (ADM) and communications. There were no significant differences on either the Balanced Inventory of Desirable Responding (BIDR) impression management (IM) or self-deceptive enhancement (SDE). Although there were no overall significant differences on the ASLOC, the females did score higher on the internal subscale than did the males. An additional comparison of socially desirable responding indicates that all scores may be invalid, especially from the female respondents.

Keywords: social desirability, safety locus of control, crew resource management, commercial pilots

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1794 Unravelling the Relationship Between Maternal and Fetal ACE2 Gene Polymorphism and Preeclampsia Risk

Authors: Sonia Tamanna, Akramul Hassan, Mohammad Shakil Mahmood, Farzana Ansari, Gowhar Rashid, Mir Fahim Faisal, M. Zakir Hossain Howlader

Abstract:

Background: Preeclampsia (PE), a pregnancy-specific hypertensive disorder, significantly impacts maternal and fetal health. It is particularly prevalent in underdeveloped countries and is linked to preterm delivery and fetal growth. The renin-angiotensin system (RAS) plays a crucial role in ensuring a successful pregnancy outcome, with Angiotensin-Converting Enzyme 2 (ACE2) being a key component. ACE2 converts ANG II to Ang-(1-7), offering protection against ANG II-induced stress and inflammation while regulating blood pressure and osmotic balance during pregnancy. The reduced maternal plasma angiotensin-converting enzyme 2 (ACE2) seen in preeclampsia might contribute to its pathogenesis. However, there has been a dearth of comprehensive research into the association between ACE2 gene polymorphism and preeclampsia. In the South Asian population, hypertension is strongly linked to two SNPs: rs2285666 and rs879922. This genotype was therefore considered, and the possible association of maternal and fetal ACE2 gene polymorphism with preeclampsia within the Bangladeshi population was evaluated. Method: DNA was extracted from peripheral white blood cells (WBCs) using the organic method, and SNP genotyping was done via PCR-RFLP. Odds ratios (OR) with 95% confidence intervals (95% CI) were calculated using logistic regression to determine relative risk. Result: A comprehensive case-control study was conducted on 51 PE patients and their infants, along with 56 control subjects and their infants. Maternal single nuvleotide polymorphisms (SNP) (rs2285666) analysis revealed a strong association between the TT genotype and preeclampsia, with a four-fold increased risk in mothers (P=0.024, OR=4.00, 95% CI=1.36-11.37) compared to their ancestral genotype CC. However, the CT genotype (rs2285666) showed no significant difference (P=0.46, OR=1.54, 95% CI=0.57-4.14). Notably, no significant correlation was found in infants, regardless of their gender. For rs879922, no significant association was observed in both mothers and infants. This pioneering study suggests that mothers carrying the ACE2 gene variant rs2285666 (TT allele) may be at higher risk for preeclampsia, potentially influencing hypertension characteristics, whereas rs879922 does not appear to be associated with developing preeclampsia. Conclusion: This study sheds light on the role of ACE2 gene polymorphism, particularly the rs2285666 TT allele, in maternal susceptibility to preeclampsia. However, rs879922 does not appear to be linked to the risk of PE. This research contributes to our understanding of the genetic underpinnings of preeclampsia, offering insights into potential avenues for prevention and management.

Keywords: ACE2, PCR-RFLP, preeclampsia, single nuvleotide polymorphisms (SNPs)

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1793 Case Study; Drilled Shafts Installation in Difficult Site Conditions; Loose Sand and High Water Table

Authors: Anthony El Hachem, Hosam Salman

Abstract:

Selecting the most effective construction method for drilled shafts under the high phreatic surface can be a challenging task that requires effective communication between the design and construction teams. Slurry placement, temporary casing, and permanent casing are the three most commonly used installation techniques to ensure the stability of the drilled hole before casting the concrete. Each one of these methods has its implications on the installation and performance of the drilled piers. Drilled shafts were designed to support a fire wall for an Energy project in Central Texas. The subsurface consisted of interlayers of sands and clays of varying shear strengths. The design recommended that the shafts be installed with temporary casing or slurry displacement due to the anticipated groundwater seepage through granular soils. During the foundation construction, it was very difficult to maintain the stability of the hole, and the contractor requested to install the shafts using permanent casings. Therefore, the foundation design was modified to ensure that the cased shafts achieve the required load capacity. Effective and continuous communications between the owner, contractor and design team during field shaft installations to mitigate the unforeseen challenges helped the team to successfully complete the project.

Keywords: construction challenges, deep foundations, drilled shafts, loose sands underwater table, permanent casing

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1792 A Map to Integrating Media into the Spanish Curriculum: The Case of California Lutheran University

Authors: Carrollyne Aasen, Laverne Seales

Abstract:

With increased Latinx communities within the United States, specifically in California, and more universities receiving designations of Hispanic-Serving institutions, Spanish programs have evolved to include more targeted and applicable practical skills. The Spanish program in the Languages and Cultures Department at California Lutheran University incorporated an interdisciplinary project with the Communication Department to create student-generated Spanish-language news inserts, which serve as a sister publication to the English-language student newspaper, The Echo. California Lutheran University is a Hispanic-Serving Institution, meaning it is an accredited undergraduate institution with full-time Hispanic/Latinx students equivalent to at least 25 percent of the total students enrolled. As a Hispanic Serving Institution with growing numbers of bilingual students, faculty, staff, and community members, the need for more information aimed at Hispanic/Latinx communities increased, resulting in the opportunity to reflect topics of interest by community members. This project was developed to fulfill the Spanish program's goals for proficiency by using the American Council on the Teaching of Foreign Languages guidelines and the university's need to support students and the community's voices. This article describes the stages from inception to production and the incorporation of journalism principles into the Spanish curriculum.

Keywords: interdisciplinary, media, foreign languages, HSI

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1791 Low-Cost Mechatronic Design of an Omnidirectional Mobile Robot

Authors: S. Cobos-Guzman

Abstract:

This paper presents the results of a mechatronic design based on a 4-wheel omnidirectional mobile robot that can be used in indoor logistic applications. The low-level control has been selected using two open-source hardware (Raspberry Pi 3 Model B+ and Arduino Mega 2560) that control four industrial motors, four ultrasound sensors, four optical encoders, a vision system of two cameras, and a Hokuyo URG-04LX-UG01 laser scanner. Moreover, the system is powered with a lithium battery that can supply 24 V DC and a maximum current-hour of 20Ah.The Robot Operating System (ROS) has been implemented in the Raspberry Pi and the performance is evaluated with the selection of the sensors and hardware selected. The mechatronic system is evaluated and proposed safe modes of power distribution for controlling all the electronic devices based on different tests. Therefore, based on different performance results, some recommendations are indicated for using the Raspberry Pi and Arduino in terms of power, communication, and distribution of control for different devices. According to these recommendations, the selection of sensors is distributed in both real-time controllers (Arduino and Raspberry Pi). On the other hand, the drivers of the cameras have been implemented in Linux and a python program has been implemented to access the cameras. These cameras will be used for implementing a deep learning algorithm to recognize people and objects. In this way, the level of intelligence can be increased in combination with the maps that can be obtained from the laser scanner.

Keywords: autonomous, indoor robot, mechatronic, omnidirectional robot

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1790 Hypoglossal Nerve Stimulation (Baseline vs. 12 months) for Obstructive Sleep Apnea: A Meta-Analysis

Authors: Yasmeen Jamal Alabdallat, Almutazballlah Bassam Qablan, Hamza Al-Salhi, Salameh Alarood, Ibraheem Alkhawaldeh, Obada Abunar, Adam Abdallah

Abstract:

Obstructive sleep apnea (OSA) is a disorder caused by the repeated collapse of the upper airway during sleep. It is the most common cause of sleep-related breathing disorder, as OSA can cause loud snoring, daytime fatigue, or more severe problems such as high blood pressure, cardiovascular disease, coronary artery disease, insulin-resistant diabetes, and depression. The hypoglossal nerve stimulator (HNS) is an implantable medical device that reduces the occurrence of obstructive sleep apnea by electrically stimulating the hypoglossal nerve in rhythm with the patient's breathing, causing the tongue to move. This stimulation helps keep the patient's airways clear while they sleep. This systematic review and meta-analysis aimed to assess the clinical outcome of hypoglossal nerve stimulation as a treatment of obstructive sleep apnea. A computer literature search of PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials was conducted from inception until August 2022. Studies assessing the following clinical outcomes (Apnea-Hypopnea Index (AHI), Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire (FOSQ), Oxygen Desaturation Indices (ODI), (Oxygen Saturation (SaO2)) were pooled in the meta-analysis using Review Manager Software. We assessed the quality of studies according to the Cochrane risk-of-bias tool for randomized trials (RoB2), Risk of Bias In Non-randomized Studies - of Interventions (ROBINS-I), and a modified version of NOS for the non-comparative cohort studies.13 Studies (Six Clinical Trials and Seven prospective cohort studies) with a total of 817 patients were included in the meta-analysis. The results of AHI were reported in 11 studies examining OSA 696 patients. We found that there was a significant improvement in the AHI after 12 months of HNS (MD = 18.2 with 95% CI, (16.7 to 19.7; I2 = 0%); P < 0.00001). Further, 12 studies reported the results of ESS after 12 months of intervention with a significant improvement in the range of sleepiness among the examined 757 OSA patients (MD = 5.3 with 95% CI, (4.75 to 5.86; I2 = 65%); P < 0.0001). Moreover, nine studies involving 699 participants reported the results of FOSQ after 12 months of HNS with a significant reported improvement (MD = -3.09 with 95% CI, (-3.41 to 2.77; I2 = 0%); P < 0.00001). In addition, ten studies reported the results of ODI with a significant improvement after 12 months of HNS among the 817 examined patients (MD = 14.8 with 95% CI, (13.25 to 16.32; I2 = 0%); P < 000001). The Hypoglossal Nerve Stimulation showed a significant positive impact on obstructive sleep apnea patients after 12 months of therapy in terms of apnea-hypopnea index, oxygen desaturation indices, manifestations of the behavioral morbidity associated with obstructive sleep apnea, and functional status resulting from sleepiness.

Keywords: apnea, meta-analysis, hypoglossal, stimulation

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