Search results for: generalized autoregressive score model

Authors: R. Hassan, J. Duncombe, E. Darke, A. Dias, K. Anderson, R. G. Middleton

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Background: NHS England has set itself the task of delivering a “Net Zero” National Health service by 2040. It is incumbent upon all health care practioners to work towards this goal. Orthopaedic surgeons are no exception. Distal radial fractures are the most common fractures sustained by the adult population. However, studiesare shortcoming on individual patient experience. The aim of this study was to assess the patient’ssatisfaction and outcomes with woodcast used in the conservative management of distal radius fractures. Methods: For all patients managed with woodcast in our unit, we undertook a structured questionnairethat included the Patient Rated Wrist Evaluation (PRWE) score, The EQ-5D-5L score, and the pain numerical score at the time of injury and six weeks after. Results: 30 patients were initially managed with woodcast.80% of patients tolerated woodcast for the full duration of their treatment. Of these, 20% didn’t tolerate woodcast and had their casts removed within 48 hours. Of the remaining, 79.1% were satisfied about woodcast comfort, 66% were very satisfied about woodcast weight, 70% were satisfied with temperature and sweatiness, 62.5% were very satisfied about the smell/odour, and 75% were satisfied about the level of support woodcast provided. During their treatment, 83.3% of patients rated their pain as five or less. Conclusion: For those who completed their treatment in woodcast, none required any further intervention or utilised the open appointment because of ongoing wrist problems. In conclusion, when woodcast is tolerated, patients’ satisfaction and outcome levels were good. However, we acknowledged 20% of patients in our series were not able to tolerate woodacst, Therefore, we suggest a comparison between the widely used synthetic plaster of Pariscasting and woodcast to come in order.

Keywords: distal radius fractures, ecological cast, sustainability, woodcast

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Authors: Ghunchq Khan

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The increase in greenhouse gas (GHGs) emissions is a main environmental problem. Diverse human activities and inappropriate economic growth have stimulated a trade-off between economic growth and environmental deterioration all over the world. The impact of economic growth on the environment has received attention as global warming and environmental problems have become more serious. The focus of this study is on carbon footprints (production and consumption) and analyses the impact of GDP per capita on carbon footprints. A balanced panel of 99 countries from 2000 to 2016 is estimated by employing autoregressive distributed lags (ARDL) model – mean group (MG) and pooled mean group (PMG) estimators. The empirical results indicate that GDP per capita has a significant and positive impact in the short run but a negative effect in the long run on the carbon footprint of production in high-income countries by controlling trade openness, industry share, biological capacity, and population density. At the same time, GDP per capita has a significant and positive impact in both the short and long run on the carbon footprint of the production of non-high-income countries. The results also indicate that GDP per capita negatively impacts the carbon footprint of consumption for high-income countries; on the other hand, the carbon footprint of consumption increases as GDP per capita grows in non-high-income countries.

Keywords: ARDL, carbon footprint, economic growth, industry share, trade openness

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Authors: S. Suman, G. N. Singh

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This research work is an effort to analyse the consequences of scrambled response technique to estimate the current population mean in two-occasion successive sampling when the characteristic of interest is sensitive in nature. The generalized estimation procedures have been proposed using sensitive auxiliary variables under additive and multiplicative scramble models. The properties of resultant estimators have been deeply examined. Simulation, as well as empirical studies, are carried out to evaluate the performances of the proposed estimators with respect to other competent estimators. The results of our studies suggest that the proposed estimation procedures are highly effective under the presence of non-response situation. The result of this study also suggests that additive scrambled response model is a better choice in the perspective of cost of the survey and privacy of the respondents.

Keywords: scrambled response, sensitive characteristic, successive sampling, optimum replacement strategy

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Authors: Vladyslav Povoroznyuk, Anna Musiienko, Nataliia Dzerovych, Roksolana Povoroznyuk

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Osteoporosis and obesity are widespread diseases in people over 50 years associated with changes in structure and body composition. Нigher body mass index (BMI) values are associated with greater bone mineral density (BMD). However, trabecular bone score (TBS) indirectly explores bone quality, independently of BMD. The aim of our study was to evaluate the relationship between the BMD and TBS parameters in Ukrainian men suffering from obesity. We examined 396 men aged 40-89 years. Depending on their BMI all the subjects were divided into two groups: Group I – patients with obesity whose BMI was ≥ 30 kg/m² (n=129) and Group II – patients without obesity and BMI of < 30 kg/m² (n=267). The BMD of total body, lumbar spine L₁-L₄, femoral neck and forearm were measured by DXA (Prodigy, GEHC Lunar, Madison, WI, USA). The TBS of L₁- L₄ was assessed by means of TBS iNsight® software installed on DXA machine (product of Med-Imaps, Pessac, France). In general, obese men had a significantly higher BMD of lumbar spine L₁-L₄, femoral neck, total body and ultradistal forearm (p < 0.001) in comparison with men without obesity. The TBS of L₁-L₄ was significantly lower in obese men compared to non-obese ones (p < 0.001). BMD of lumbar spine L₁-L₄, femoral neck and total body significantly differ in men aged 40-49, 50-59, 60-69, and 80-89 years (p < 0.05). At the same time, in men aged 70-79 years, BMD of lumbar spine L₁-L₄ (p=0.46), femoral neck (p=0.18), total body (p=0.21), ultra-distal forearm (p=0.13), and TBS (p=0.07) did not significantly differ. A significant positive correlation between the fat mass and the BMD at different sites was observed. However, the correlation between the fat mass and TBS of L₁-L₄ was also significant, though negative.

Keywords: bone mineral density, trabecular bone score, obesity, men

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Authors: Ionel D. Craiu, Mihai Nedelcu

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Thin-walled cylinders are often used by the offshore industry as columns of floating installations. Based on observed strains, the inverse Finite Element Method (iFEM) may rebuild the deformation of structures. Structural Health Monitoring uses this approach extensively. However, the number of in-situ strain gauges is what determines how accurate it is, and for shell structures with complicated deformation, this number can easily become too high for practical use. Any thin-walled beam member's complicated deformation can be modeled by the Generalized Beam Theory (GBT) as a linear combination of pre-specified cross-section deformation modes. GBT uses bar finite elements as opposed to shell finite elements. This paper proposes an iFEM/GBT formulation for the shape sensing of thin-walled cylinders based on these benefits. This method significantly reduces the number of strain gauges compared to using the traditional inverse-shell finite elements. Using numerical simulations, dent damage detection is achieved by comparing the strain distributions of the undamaged and damaged members. The effect of noise on strain measurements is also investigated.

Keywords: damage detection, generalized beam theory, inverse finite element method, shape sensing

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Authors: Pınar Yardımcı

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This paper tries to answer to the questions whether or not trade openness cause economic growth and trade policy changes is good for Turkey as a developing country in global economy before and after 1980. We employ Johansen cointegration and Granger causality tests with error correction modelling based on vector autoregressive. Using WDI data from the pre-1980 and the post-1980, we find that trade openness and economic growth are cointegrated in the second term only. Also the results suggest a lack of long-run causality between our two variables. These findings may imply that trade policy of Turkey should concentrate more on extra complementary economic reforms.

Keywords: globalization, trade policy, economic growth, openness, cointegration, Turkey

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Authors: Gali Moritz, Jacqueline H. Becker, Jyoti V. Ankam, Kimberly Arcoleo, Matthew Wysocki, Roee Holtzer, Juan Wisnivesky, Paula J. Busse, Alex D. Federman, Sunit P. Jariwala, Jonathan M. Feldman

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Objective: Cognitive impairment (CI), whose incidence is greater among ethnic/racial minorities, is a significant barrier to asthma self-management (SM) behaviors and outcomes in older adults. The aim of this study was to examine the relationships between CI, assessed using the Montreal Cognitive Assessment (MoCA), and asthma SM behaviors and outcomes in a sample of predominantly Black and Hispanic participants. Additionally, we evaluated whether using two different MoCA cutoff scores influenced the association between CI and study outcomes. Methods: Baseline cross-sectional data were extracted from a longitudinal study of older adults with asthma (N=165) age≥ 60 years and used for analysis. Cognition was assessed using the MoCA. Asthma control, asthma-related quality of life (QOL), inhaled corticosteroid (ICS) dosing, and ICS adherence were assessed using self-report. The inhaler technique was observed and rated. Results: Using established MoCA cutoff scores of 23 and 26 yielded 45% and 74% CI rates, respectively. CI, defined using the 23 cutoff score, was significantly associated with worse asthma control (p=.04) and worse ICS adherence (p=.01). With a cutoff score of 26, only asthma-related QOL was significantly associated with CI (p=.03). Race/ethnicity and education did not moderate the relationships between CI and asthma SM behaviors and outcomes. Conclusions: CI in older adults with asthma is associated with important clinical outcomes, but this relationship is influenced by the cutoff score used to define CI.

Keywords: cognition, respiratory, elderly, testing, adherence, validity

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Authors: Jiayue Guo, Lili You

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Background: Children and adolescent health are crucial for both personal well-being and the nation's future health landscape. Health Literacy (HL) is important in enabling adolescents to self-manage their health, a fundamental step towards health empowerment. However, there are limited tools for assessing HL among elementary and junior high school students. This study aims to construct and validate a test-based HL scale for Chinese students, offering a scientific reference for cross-cultural HL tool development. Methods: We conducted a cross-sectional online survey. Participants were recruited from a stratified cluster random sampling method, a total of 4189 Chinese in-school primary and secondary students. The development of the scale was completed by defining the concept of HL, establishing the item indicator system, screening items (7 health content dimensions), and evaluating reliability and validity. Delphi method expert consultation was used to screen items, the Rasch model was conducted for quality analysis, and Cronbach’s alpha coefficient was used to examine the internal consistency. Results: We developed four versions of the HL scale, each with a total score of 100, encompassing seven key health areas: hygiene, nutrition, physical activity, mental health, disease prevention, safety awareness, and digital health literacy. Each version measures four dimensions of health competencies: knowledge, skills, motivation, and behavior. After the second round of expert consultation, the average importance score of each item by experts is 4.5–5.0, and the coefficient of variation is 0.000–0.174. The knowledge and skills dimensions are judgment-based and multiple-choice questions, with the Rasch model confirming unidimensionality at a 5.7% residual variance. The behavioral and motivational dimensions, measured with scale-type items, demonstrated internal consistency via Cronbach's alpha and strong inter-item correlation with KMO values of 0.924 and 0.787, respectively. Bartlett's test of sphericity, with p-values <0.001, further substantiates the scale's reliability. Conclusions: The new test-based scale, designed to evaluate competencies within a multifaceted framework, aligns with current international adolescent literacy theories and China's health education policies, focusing not only on knowledge acquisition but also on the application of health-related thinking and behaviors. The scale can be used as a comprehensive tool for HL evaluation and a reference for other countries.

Keywords: adolescent health, Chinese, health literacy, rasch model, scale development

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Authors: Adriano Pinargote, Josue Mosquera, Eduardo Montero, Dalton Noboa, Jenny Venegas, Genesis Vasquez Escuela

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In the framework of Pre University learning of the Polytechnic School of the Litoral, Guayaquil, Ecuador, the methodology of Active Learning (Flipped Classroom) has been implemented for applicants who wish to obtain a quota within the university. To complement the Active Learning cycle, it has been proposed that the respective students influence the qualification of their work groups, for which a web platform has been created that allows them to evaluate the performance of their peers through a digital coevaluation that measures through statistical methods, the group and individual performance score that can reflect in numbers a weighting score corresponding to the grade of each student. Their feedback provided by the group help to improve the performance of the activities carried out in classes because the note reflects the commitment with their classmates shown in the class, within this analysis we will determine if this implementation directly influences the performance of the grades obtained by the student.

Keywords: active learning, coevaluation, flipped classroom, pre university

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Authors: Steven W. Carruthers

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The purpose of the present research is to equate two test forms as part of a study to evaluate the educational effectiveness of the ARTé: Mecenas art history learning game. The researcher applied Item Response Theory (IRT) procedures to calculate item, test, and mean-sigma equating parameters. With the sample size n=134, test parameters indicated “good” model fit but low Test Information Functions and more acute than expected equating parameters. Therefore, the researcher applied equipercentile equating and linear equating to raw scores and compared the equated form parameters and effect sizes from each method. Item scaling in IRT enables the researcher to select a subset of well-discriminating items. The mean-sigma step produces a mean-slope adjustment from the anchor items, which was used to scale the score on the new form (Form R) to the reference form (Form Q) scale. In equipercentile equating, scores are adjusted to align the proportion of scores in each quintile segment. Linear equating produces a mean-slope adjustment, which was applied to all core items on the new form. The study followed a quasi-experimental design with purposeful sampling of students enrolled in a college level art history course (n=134) and counterbalancing design to distribute both forms on the pre- and posttests. The Experimental Group (n=82) was asked to play ARTé: Mecenas online and complete Level 4 of the game within a two-week period; 37 participants completed Level 4. Over the same period, the Control Group (n=52) did not play the game. The researcher examined between group differences from post-test scores on test Form Q and Form R by full-factorial Two-Way ANOVA. The raw score analysis indicated a 1.29% direct effect of form, which was statistically non-significant but may be practically significant. The researcher repeated the between group differences analysis with all three equating methods. For the IRT mean-sigma adjusted scores, form had a direct effect of 8.39%. Mean-sigma equating with a small sample may have resulted in inaccurate equating parameters. Equipercentile equating aligned test means and standard deviations, but resultant skewness and kurtosis worsened compared to raw score parameters. Form had a 3.18% direct effect. Linear equating produced the lowest Form effect, approaching 0%. Using linearly equated scores, the researcher conducted an ANCOVA to examine the effect size in terms of prior knowledge. The between group effect size for the Control Group versus Experimental Group participants who completed the game was 14.39% with a 4.77% effect size attributed to pre-test score. Playing and completing the game increased art history knowledge, and individuals with low prior knowledge tended to gain more from pre- to post test. Ultimately, researchers should approach test equating based on their theoretical stance on Classical Test Theory and IRT and the respective  assumptions. Regardless of the approach or method, test equating requires a representative sample of sufficient size. With small sample sizes, the application of a range of equating approaches can expose item and test features for review, inform interpretation, and identify paths for improving instruments for future study.

Keywords: effectiveness, equipercentile equating, IRT, learning games, linear equating, mean-sigma equating

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Authors: Sara Ramos Contioso

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The premiere of Anton Bruckner's Requiem in Dm, in September 1849, represents a turning point in the composer's creative evolution. This Mass of the Dead, which was dedicated to the memory of his esteemed friend and mentor Franz Sailer, establishes the beginning of a new creative aesthetic in the composer´s production and links its liturgical development, which is contextualized in the monastery of St. Florian, to the use of a range of musicals possibilities that are projected by Bruckner on an orchestral texture with choir and organ. Set on a strict tridentine ritual model, this requiem exemplifies the religious aesthetics of a composer that is committed to the Catholic faith and that also links to its structure the reinterpretation of a religious model that, despite being romantic, shows a strong influence derived from the baroque or the Viennese Classicism language. Consequently, the study responds to the need to show the survival of the Requiem Mass within the romantic context of Vienna. Therefore, it draws on a detailed analysis of the score and the creative context of the composer with the intention of linking the work to the tradition of the genre and also specifying the stylistic particularities of its musical model within a variability of possibilities such as the contrasting precedents of Mozart, Haydn, Cherubini or Berlioz´s requiems. Tradition or modernity, liturgy or concert hall are aesthetic references that will condition the development of the Requiem Mass in the middle of the nineteenth century. In this context, this paper tries to recover Bruckner's Requiem in Dm as a musical model of the romantic ritual of deceased and as a stylistic reference of a creative composition that will condition the development of later liturgical works such as Liszt or DeLange (1868) ones.

Keywords: liturgy, religious symbolism, requiem, romanticism

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Authors: Omar Sorour, Michael Leahy, Thomas Irvine, Vladimir Koren

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Introduction: Covid encephalitis is a rare yet dangerous complication, particularly affecting the older and immunocompromised. Symptoms range from confusion to delirium, coma, and seizures. Although neurological manifestations have become more well-characterized in COVID patients, little is known about whether priorneurological abnormalities may predispose patients to COVID encephalopathy. Case Description: A 73 y.o. male with a CT and MRI-confirmed stable, prior 9 mm cavernoma in the right frontal lobe and no past history of seizures was hospitalized with generalized weakness, abdominal pain, nausea, and shortness of breath with subsequent COVID pneumonia. Three days after the initial presentation, the patient developed a spontaneous generalized tonic-clonic seizure consistent with presumed COVID encephalitis, along with somnolence and confusion. A day later, the patient had two other seizure episodes. Follow-up EEG suggested an inter-ictal epileptic focus with sharp waves corresponding to roughly the same location as the patient’s pre-existing cavernoma. The patient’s seizures stopped shortly thereafter, while his encephalopathy continued for days. Conclusion: We illustrate that a pre-existing anatomic cortical abnormality may act as a potential nidus for new-onset seizure activity in the context of suggested COVID encephalopathy. Future studies may further demonstrate that manifestations of COVIDencephalopathy in certain patients may be more predictable than initially assumed.

Keywords: cavernoma, covid, encephalopathy, seizures

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Authors: Qisheng Hu, Jianglei Han, Yue Yang, My Hoa Ha

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When a company is considering purchasing software for commercial use, contract risk assessment is critical to identify risks to mitigate the potential adverse business impact, e.g., security, financial and regulatory risks. Contract risk assessment requires reviewers with specialized knowledge and time to evaluate the legal documents manually. Specifically, validating contracts for a software vendor requires the following steps: manual screening, interpreting legal documents, and extracting risk-prone segments. To automate the process, we proposed a framework to assist legal contract document risk identification, leveraging pre-trained deep learning models and natural language processing techniques. Given a set of pre-defined risk evaluation problems, our framework utilizes the pre-trained transformer-based models for question-answering to identify risk-prone sections in a contract. Furthermore, the question-answering model encodes the concatenated question-contract text and predicts the start and end position for clause extraction. Due to the limited labelled dataset for training, we leveraged transfer learning by fine-tuning the models with the CUAD dataset to enhance the model. On a dataset comprising 287 contract documents and 2000 labelled samples, our best model achieved an F1 score of 0.687.

Keywords: contract risk assessment, NLP, transfer learning, question answering

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Authors: Sohaib Raza, Parvez Mantry

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Frailty is a multi-system impairment associated with stressors such as age, disease, and invasive surgical procedures. This multi-system impairment can lead to increased post-transplant mortality and functional decline. Additionally, the prevalence and/or severity of frailty increases when patient pre-habilitation is unsatisfactory or lacking. We conducted a retrospective study to examine whether the COVID-19 Pandemic, and subsequent lack of patient access to pre-habilitation and physical therapy resources, led to an increase in the prevalence and severity of frailty, sarcopenia, and other comorbidities including diabetes, hypertension, and COPD. Secondarily, we examined the correlation between patient survival rate and liver frailty index as well as muscle wasting/sarcopenia. Data were analyzed in order to correlate variables associated with these parameters. Three hundred sixty-nine liver transplant candidates at Methodist Dallas Medical Center were administered pre-transplant frailty assessments, which consisted of chair stands, grip strength, and position balance time. A frailty score less than 3.2 indicated a robust condition, a score from 3.3 to 4.4 indicated a pre-frail condition, and a score greater than 4.5 indicated a frail condition. Greater than 50 percent of patients were found to have muscle wasting in the COVID-19 period (March 13, 2020 to February 28, 2022), an increase of 16.5 percent from the pre-COVID period (April 1st, 2018 to March 12, 2020). Additionally, sarcopenia was associated with a two-fold increase in patient mortality rate. Furthermore, high liver frailty index scores were associated with increased patient mortality. However, there was no significant difference in liver frailty index or number of comorbidities between patients in the two cohorts. Conclusion: The COVID-19 Pandemic exacerbated sarcopenia-related muscle wasting in liver transplant candidates, and patient survival rate was directly correlated with liver frailty index score and the presence of sarcopenia.

Keywords: frailty, sarcopenia, covid-19, patient mortality, pre-habilitation, liver transplant candidates

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Authors: Go Bong Choi, Shin Je Lee, Sung Jin Yoo, Gibaek Lee, Jong Min Lee

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In South Korea, it is difficult to obtain data for statistical pipe assessment. In this paper, to address these issues, we find that various statistical model presented before is how data mixed with noise and are whether apply in South Korea. Three major type of model is studied and if data is presented in the paper, we add noise to data, which affects how model response changes. Moreover, we generate data from model in paper and analyse effect of noise. From this we can find robustness and applicability in Korea of each model.

Keywords: proportional hazard model, survival model, water main deterioration, ecological sciences

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Authors: Ubu Isaiah, Gambo D.

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Haematological studies are an important diagnosis of nutritional studies. The study investigated the haematological parameters of West African Dwarf (WAD) goats fed a diet containing different levels of sodium humate. Twenty (20) WAD bucks weighing between 8.154 ± 0.340 kg were used for this study. The bucks were randomly allotted to four dietary treatments containing 0, 5, 10, and 15 g/kg diet of sodium humate laid out as a completely randomized design. Data on haematological parameters were obtained and statistically analysed using the generalized linear model (GLM) of the Statistical Package for Social Sciences (SPSS) (version 23). Results showed that sodium humate supplementation (p <0.05) has no significant effect on Neutrophils, Eosinophil, Basophils, and Monocytes, respectively. It was recommended up to 15 g/kg diet supplementation of sodium humate sufficiently enhance the performance of WAD goats as well the improving their haematological indices.

Keywords: haematological indices, goat, sodium humate

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Authors: Hassan Okati-Aliabad, Athare Nazri-Panjaki, Mahdi Mohammadi, Alireza Ansari-Moghaddam

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Aims: In type 2 diabetes control, self-management is an effective way to minimize the risk of developing complications and improve the quality of life. Self-determination theory (SDT) proposed a promising explanatory framework to predict self-regulated behavior, which was particularly relevant to self-management. This study aimed to investigate whether SDT constructs can affect the self-management and controlling glycated hemoglobin A1c levels in type 2 diabetic patients or not. Methods: This cross-sectional study was conducted from August to December 2022 at two diabetes clinics in Zahedan, Iran. The study included 300 patients with type 2 diabetes. Data collection was done using a researcher-administrated questionnaire that included demographic data, diabetes self-care activities, and self-determination constructs including autonomous support, autonomous motivation, and perceived competence. Results: The mean of the overall score of self-care activities was 34.62 ±11.86 out of a maximum of 70. Patients in the fourth quarter (wealthiest) of the socioeconomic status had the highest mean self-care score (P=0.003). There was a significant relationship between diet score with perceived competence (P=0.009). Perceived competence (P˂0.001) and controlled self-regulation (P˂0.001) were the predictors of exercise scores in diabetes patients. Independent self-regulation (P˂0.001, r=0.21) and overall self-regulation (P=0.001,r=0.19) were significantly related to blood-glucose testing scores. There was a significant relationship between foot care score with perceived competence (P=0.048, r=0.11) and autonomous support (P=0.013, r=0.14). Multiple regression showed that exercise was the predictor of HbA1c (P=0.014). Conclusion: Exercise is crucial for achieving good individualized glycemic control and reducing the risk of diabetes complications. The findings provided valuable insights into the determinants of self-care activities in patients with type 2 diabetes and underscore the need for interventions that address socioeconomic disparities, enhance perceived competence, and provide autonomy support to improve diabetes self-care.

Keywords: self-care activities, diabetes mellitus type 2, blood glucose self-monitoring, health behaviors, self-determination theory

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Authors: Adian Fatchur Rochim, Abdul Muis, Riri Fitri Sari

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H-index has been widely used as a performance indicator of researchers around the world especially in Indonesia. The Government uses Scopus and Google scholar as indexing references in providing recognition and appreciation. However, those two indexing services yield to different H-index values. For that purpose, this paper evaluates the difference of the H-index from those services. Researchers indexed by Webometrics, are used as reference’s data in this paper. Currently, Webometrics only uses H-index from Google Scholar. This paper observed and compared corresponding researchers’ data from Scopus to get their H-index score. Subsequently, some researchers with huge differences in score are observed in more detail on their paper’s publisher. This paper shows that the H-index of researchers in Google Scholar is approximately 2.45 times of their Scopus H-Index. Most difference exists due to the existence of uncertified publishers, which is considered in Google Scholar but not in Scopus.

Keywords: Google Scholar, H-index, Scopus, performance indicator

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Authors: Pedro M. Abreu, Bruno R. Mendes

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The management of pharmacotherapy and the process of dispensing medicines is becoming critical in clinical pharmacy due to the increase of incidence and prevalence of chronic diseases, the complexity and customization of therapeutic regimens, the introduction of innovative and more expensive medicines, the unbalanced relation between expenditure and revenue as well as due to the lack of rationalization associated with medication use. For these reasons, co-payments emerged in Europe in the 70s and have been applied over the past few years in healthcare. Co-payments lead to a rationing and rationalization of user’s access under healthcare services and products, and simultaneously, to a qualification and improvement of the services and products for the end-user. This analysis, under hospital practices particularly and co-payment strategies in general, was carried out on all the European regions and identified four reference countries, that apply repeatedly this tool and with different approaches. The structure, content and adaptation of European co-payments were analyzed through 7 qualitative attributes and 19 performance indicators, and the results expressed in a scorecard, allowing to conclude that the German models (total score of 68,2% and 63,6% in both elected co-payments) can collect more compliance and effectiveness, the English models (total score of 50%) can be more accessible, and the French models (total score of 50%) can be more adequate to the socio-economic and legal framework. Other European models did not show the same quality and/or performance, so were not taken as a standard in the future design of co-payments strategies. In this sense, we can see in the co-payments a strategy not only to moderate the consumption of healthcare products and services, but especially to improve them, as well as a strategy to increment the value that the end-user assigns to these services and products, such as medicines.

Keywords: clinical pharmacy, co-payments, healthcare, medicines

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Authors: Sumreen Hafeez

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Objective: The objective of this study is to compare the efficacy of terbinafine versus Itraconazole in the treatment of tinea corporis. Study design: The study design is a randomized controlled trial. Place and duration of study: This study was conducted at the Department of Dermatology, DHQ Hospital, Sheikhupura, during the duration of July 2023 to December 2023. Methodology: A total of 50 cases (25 in both groups) with Tinea corporis were included. Then, patients were randomly divided into two groups. In group A, patients were given terbinafine. In group B, patients were given Itraconazole. Then, the patients were followed up for 2, 4, 6, and 8 weeks. On each visit, patients were examined for complete resolution of tinea by using the total body surface area index, and they were assessed for resolution of lesions. All the data was recorded in proforma and then entered & analyzed through SPSS version 26. Results: In the terbinafine group, the mean age of the patients was 35.16 ± 8.76 years. In the itraconazole group, the mean age of the patients was 28.36 ± 10.65 years. In the terbinafine group, there were 15 (60%) males and 10 (40%) females. Meanwhile, in the itraconazole group, there were 8 (32%) males and 17 (68%) females. Moreover, in the terbinafine group, the baseline BSI score was 6.44 ± 3.19, and this score was reduced to 3.64 + 2.11 after 4 weeks of treatment. In this group, the efficacy (complete cure within 4 weeks) was achieved in 6 (24%) cases. On the other hand, in the itraconazole group, the baseline BSI score was 7.20 ± 2.99, which was reduced to 1.75 + 0.50 after 4 weeks of treatment, and the efficacy (complete cure within 4 weeks) was achieved in 13(52%) cases in this group. Conclusion: We found that itraconazole has better efficacy than terbinafine for tinea corporis. Thus, in the future, Itraconazole can be a drug of choice for such cases.

Keywords: terbinafine, Itraconazole, Tinea corporis, topical treatment, body surface area

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Authors: Nuralam Sam, Irawan Yusuf, Irfan Idris, Endi Adnan

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The most case in the shoulder in the the adult is the frozen shoulder. It make an uncomfortable sensation which disturbance daily activity. The studies of frozen shoulder are still limited. This study used a true experimental pre and post test design with a group design. The participant underwent dextrose prolotherapy injection in the rotator cuff, intraarticular glenohumeral joint, long head tendon biceps, and acromioclavicular joint injections with 15% dextrose, respectively, at week 2, week 4, and week 6. Participants were followed for 12 weeks. The specific biomarker MMP and TIMP, ROM, DASH score were measured at baseline, at week 6, and week 12. The data were analyzed by multivariate analysis (repeated measurement ANOVA, Paired T-Test, and Wilcoxon) to determine the effect of the intervention. The result showed a significant decrease in The Disability of the Arm, Shoulder, and Hand (DASH) score in prolo injection patients in each measurement week (p < 0.05). While the measurement of Range of Motion (ROM), each direction of shoulder motion showed a significant difference in average each week, from week 0 to week 6 (p <0.05).Dextrose prolotherapy injection results give a significant improvement in functional outcome of the shoulder joint, and ROMand did not show significant results in assessing the specific biomarker, MMP-1, and TIMP-1 in tissue repair. This study suggestion an alternative to the use of injection prolotherapy in Frozen shoulder patients, which has fewer side effects and better effectiveness than the use of corticosteroid injections.

Keywords: frozen shoulder, ROM, DASH score, prolotherapy, MMP-1, TIMP-1

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Authors: Abdmohammad Mousavi, Mohsen Shams, Mehdi Akbartabar Toori, Ali Mousavizadeh, Mohammad Ali Morowatisharifabad

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Introduction: The effectiveness of Transtheoretical Model constructs on dietary behavior change has been subject to questions by some studies. The objective of this study was to determine the relationship between self–efficacy and decisional balance as mediator variables and transfer obese and overweight women among the stages of behavior change of calorie balanced dietary intake. Method: In this cross-sectional study, 448 obese and overweight 20-44 years old women were selected from three health centers in Yasuj, a city in south west of Iran. Anthropometric data were measured using standard techniques. Demographic, stages of change, self-efficacy and decisional balance data were collected by questionnaires and analyzed using One–Way ANOVA and Generalized Linear Models tests. Results: Demographic and anthropometric variables were not different significantly in different stages of change related to calorie intake except the pre-high school level of education (P=.047, OR=502, 95% CI= .255 ~ .990). Mean scores of Self-efficacy ( F(4.425)= 27.09, P= .000), decisional balance (F(4.394), P= .004), and pros (F(4.430)=5.33, P=000) were different significantly in five stages of change. However, the cons did not show a significant change in this regard (F(4.400)=1.83, P=.123). Discussion: Women movement through the stages of changes for calorie intake behavior can be predicted by self efficacy, decisional balance and pros.

Keywords: transtheoretical model, stages of change, self efficacy, decisional balance, calorie intake, women

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Authors: Mohammad Shokoohi-Yekta, Hamid Mirebrahim

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A body of research has been devoted to investigating the preferences of computer programmers. These researches used various questionnaires to find out what programming language is most popular among programmers. The problem with such research is that the programmers are usually familiar with only a few languages; therefore, disregarding a number of other languages which might have characteristics that match their preferences more closely. To overcome such a problem, we decided to investigate the preferences of programmers in regards to the characteristics of languages, which help us to discover the languages that include the most characteristics preferred by the users. We conducted a user study to measure the preferences of programmers on different characteristics of programming languages and then tried to compare existing languages in the areas of application, Web and system programming. Overall, the results of our study indicated that the Ruby programming language has the highest preference score in the two areas of application and Web, and C++ has the highest score in the system area. The results of our study can also help programming language designers know the characteristics they should consider when developing new programming languages in order to attract more programmers.

Keywords: object orientation, programming language design, programmers' preferences, characteristic

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Authors: Chokri Slim

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The relative failure of simultaneous equation models in the seventies has led researchers to turn to other approaches that take into account the dynamics of economic and financial systems. In this paper, we use an approach based on vector autoregressive model that is widely used in recent years. Their popularity is due to their flexible nature and ease of use to produce models with useful descriptive characteristics. It is also easy to use them to test economic hypotheses. The standard econometric techniques assume that the series studied are stable over time (stationary hypothesis). Most economic series do not verify this hypothesis, which assumes, when one wishes to study the relationships that bind them to implement specific techniques. This is cointegration which characterizes non-stationary series (integrated) with a linear combination is stationary, will also be presented in this paper. Since the work of Johansen, this approach is generally presented as part of a multivariate analysis and to specify long-term stable relationships while at the same time analyzing the short-term dynamics of the variables considered. In the empirical part, we have applied these concepts to study the dynamics of of the exchange rate in Tunisia, which is one of the most important economic policy of a country open to the outside. According to the results of the empirical study by the cointegration method, there is a cointegration relationship between the exchange rate and its determinants. This relationship shows that the variables have a significant influence in determining the exchange rate in Tunisia.

Keywords: stationarity, cointegration, dynamic models, causality, VECM models

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Authors: Krishna Dahiya, Esha Charaya

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Induction of labour is a common obstetrical intervention. Around 1 in every 4 patient undergo induction of labour for different indications Purpose: To study the efficacy of the combination of Foley bulb and vaginal misoprostol in comparison to vaginal misoprostol alone for cervical ripening and induction of labour. Methods: A prospective randomised study was conducted on 150 patients with term singleton pregnancy admitted for induction of labour. Seventy-five patients were induced with both Foley bulb, and vaginal misoprostol and another 75 were given vaginal misoprostol alone for induction of labour. Both groups were then compared with respect to change in Bishop score, induction to the active phase of labour interval, induction delivery interval, duration of labour, maternal complications and neonatal outcomes. Data was analysed using statistical software SPSS version 11.5. Tests with P,.05 were considered significant. Results: The two groups were comparable with respect to maternal age, parity, gestational age, indication for induction, and initial Bishop scores. Both groups had a significant change in Bishop score (2.99 ± 1.72 and 2.17 ± 1.48 respectively with statistically significant difference (p=0.001 S, 95% C.I. -0.1978 to 0.8378). Mean induction to delivery interval was significantly lower in the combination group (11.76 ± 5.89 hours) than misoprostol group (14.54 ± 7.32 hours). Difference was of 2.78 hours (p=0.018,S, 95% CI -5.1042 to -0.4558). Induction to delivery interval was significantly lower in nulliparous women of combination group (13.64 ± 5.75 hours) than misoprostol group (18.4±7.09 hours), and the difference was of 4.76 hours (p=0.002, S, 95% CI 1.0465 to 14.7335). There was no difference between the groups in the mode of delivery, infant weight, Apgar score and intrapartum complications. Conclusion: From the present study it was concluded that addition of Foley catheter to vaginal misoprostol have the synergistic effect and results in early cervical ripening and delivery. These results suggest that the combination may be used to achieve timely and safe delivery in the presence of an unfavorable cervix. A combination of the Foley bulb and vaginal misoprostol resulted in a shorter induction-to-delivery time when compared with vaginal misoprostol alone without increasing labor complications.

Keywords: Bishop score, Foley catheter, induction of labor, misoprostol

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Authors: Gaye Demi̇rtaş Adli

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Research: It was conducted to determine the factors affecting the fear of self-injection and self-pricking of fingers of diabetic individuals.The study was conducted as a cross-sectional, relation-seeking, and descriptive study. The study was conducted on 122 patients who had just started insulin therapy. Data were obtained through The Descriptive Patient Form, The Diabetic Self-Injection, and the Fear of Testing Questionnaire Form (D-FISQ). Descriptive statistical methods used in the evaluation of data are the Mann-Whitney U test, Kruskal-Wallis H test, and the Spearman correlation. The factors affecting the scale scores were evaluated with multiple linear regression analysis. The value of P<0.05 was considered statistically significant. Study group: 56.6% of the patients are male patients. Fear of self-injection (injection), fear of self-testing (test), and total fear (total) scores of women were found to be statistically higher than men (p<0.001). Age, gender, and pain experience were important variables that affected patients' fear of injections. With a one-unit increase in age, the injection fear score decreased by 0.13 points, and the mean injection fear score of women was 2.11 points higher than that of men. It was determined that the patient's age, gender, living with whom, and blood donation history were important variables affecting the fear of self-testing. It is seen that the fear test score decreases by 0.18 points with an increase in age by one unit, and the fear test scores of women compared to men are on average 3,358 points, the fear test scores of those living alone are 4,711 points compared to those living with family members, and the fear test scores of those who do not donate blood are 2,572 compared to those who donate blood score, it was determined that those with more pain experience were 3,156 points higher on average than those with less fear of injection. As a result, it was seen that the most important factors affecting the fear of insulin injection and finger punching in individuals with diabetes were age, gender, pain experience, living with whom, and blood donation history.

Keywords: diabetes, needle phobia, fear of injection, insulin injection

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Authors: Joe Collins, Matthias Rother

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Background: Oral non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for the relief of joint pain during and post-exercise. However, oral NSAIDs increase the risk of systemic side effects, even in healthy individuals, and retard recovery from muscle soreness. TDT 064 (Flexiseq®), a topical formulation containing ultra-deformable drug-free Sequessome™ vesicles, has demonstrated equivalent efficacy to oral celecoxib in reducing osteoarthritis-associated joint pain and stiffness. TDT 064 does not cause NSAID-related adverse effects. We describe clinical study data and a case report on the effectiveness of TDT 064 in reducing joint pain after exercise. Methods: Participants with a pain score ≥3 (10-point scale) 12–16 hours post-exercise were randomized to receive TDT 064 plus oral placebo, TDT 064 plus oral ketoprofen, or ketoprofen in ultra-deformable phospholipid vesicles plus oral placebo. Results: In the 168 study participants, pain scores were significantly higher with oral ketoprofen plus TDT 064 than with TDT 064 plus placebo in the 7 days post-exercise (P = 0.0240) and recovery from muscle soreness was significantly longer (P = 0.0262). There was a low incidence of adverse events. These data are supported by clinical experience. A 24-year-old male professional rugby player suffered a traumatic lisfranc fracture in March 2014 and underwent operative reconstruction. He had no relevant medical history and was not receiving concomitant medications. He had undergone anterior cruciate ligament reconstruction in 2008. The patient reported restricted training due to pain (score 7/10), stiffness (score 9/10) and poor function, as well as pain when changing direction and running on consecutive days. In July 2014 he started using TDT 064 twice daily at the recommended dose. In November 2014 he noted reduced pain on running (score 2-3/10), decreased morning stiffness (score 4/10) and improved joint mobility and was able to return to competitive rugby without restrictions. No side effects of TDT 064 were reported. Conclusions: TDT 064 shows efficacy against exercise- and injury-induced joint pain, as well as that associated with osteoarthritis. It does not retard muscle soreness recovery after exercise compared with an oral NSAID, making it an alternative approach for the treatment of joint pain during and post-exercise.

Keywords: exercise, joint pain, TDT 064, phospholipid vesicles

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Authors: Rashmi Dubey

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The study aims at investigating the onset of thermal convection in an inclined porous layer saturated with a non-Newtonian fluid. The layer is infinitely extended and has a finite width confined between two boundaries with constant pressure conditions, where the lower one is maintained at a higher temperature. Over the years, this area of research has attracted many scientists and researchers, for it has a plethora of applications in the fields of sciences and engineering, such as in civil engineering, geothermal sites, petroleum industries, etc.Considering the possibilities in a practical scenario, an inclined porous layer is considered, which can be used to develop a generalized model applicable to any inclination. Using the isobaric boundaries, the hydrodynamic boundary conditions are derived for the power-law model and are used to obtain the basic state flow. The convection in the basic state flow is driven by the thermal buoyancy in the flow system and is carried away further due to hydrodynamic boundaries. A linear stability analysis followed by a normal-mode analysis is done to investigate the onset of convection in the buoyancy-driven flow. The analysis shows that the convective instability is always initiated by the non-traveling modes for the Newtonian fluid, but prevails in the form of oscillatory modes, for up to a certain inclination of the porous layer. However, different behavior is observed for the dilatant and pseudoplastic fluids.

Keywords: thermal convection, linear stability, porous media flow, Inclined porous layer

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Authors: Patrick Mkhanyiseli Zimu

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A sedentary lifestyle and insufficient physical activity (PA) increases the risk of developing chronic non-communicable diseases (NCDs). Knowing the PA levels and patterns of adolescents from different socio-economic backgrounds is important to direct programs at schools and in communities to prevent NCDs risk factors, which can have long-term effects on the health of the adolescents. The study aimed to investigate adolescent PA levels, patterns, and influencing factors (age, gender, socio-economic status). The 353 participants (203 females and 150 males) from eight low socio-economic (LSES) and middle socio-economic (MSES) public secondary schools completed a Physical Activity Questionnaire for Adolescents (PAQ-A). The PAQ-A is a seven day recall instrument that assesses general estimates of PA levels and patterns for high school learners in Grades 9-12 and provides a summary of physical activity scores derived from seven items, each scored on a 5-point Likert scale. The seven items were PA during spare time and five domains (during physical education, lunch break, after school, in the evenings, on the weekend) and selecting one statement that described participant’s physical activity behaviour. The PA Levels (x̄=2.61, SD=.74) were below the international PA cut-off points of x̄=2.75. Physical education (PE) showed the highest PA score (x̄=3.05, SD=1.21) and lunch break showed the lowest PA score (x̄=2.09, SD=1.14). Positive correlations occurred between PA levels and SES (r=.122, p=0.022), and PA and gender (r=.223, p= 0.0001). LSES participant’s PA score was significantly lower (x̄=2.52; SD=.73) than those from MSES (x̄=2.70; SD=.74, p=0.022). Adolescents from low and middle socio-economic status communities are not sufficiently active. Their average PA score of 2.61 is below the PAQ-A global criterion referenced cut-off points of 2.75, which is considered sufficiently physically active for adolescents to ensure both short- and long-term health benefits. As adolescents are not sufficiently active, collaborative school and community PA programs need to be implemented to supplement physical education in order to prevent short- and long-term health problems.

Keywords: adolescents, health promotion, physical activity, physical education

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Authors: Akram Sadat Jafari Roodbandi, Parisa Kahani, Fatollah Rahimi Bafrani, Ali Dehghan, Nava Seyedi, Vafa Feyzi, Zohreh Forozanfar

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Introduction: Movement function is considered as the ability to produce and maintain balance, stability, and movement throughout the movement chain. Having a score of 14 and above on 7 sub-tests in the functional movement screening (FMS) test shows agility and optimal movement performance. On the other hand, the person's body is an important factor in physical fitness and optimal movement performance. The aim of this study was to identify effective anthropometric dimensions in increasing motor function. Methods: This study was a descriptive-analytical and cross-sectional study using simple random sampling. FMS test and 25 anthropometric dimensions and subcutaneous in five body regions measured in 139 healthy students of Bam University of Medical Sciences. Data analysis was performed using SPSS software and univariate tests and linear regressions at a significance level of 0.05. Results: 139 students were enrolled in the study, 51.1% (71 subjects) and the rest were female. The mean and standard deviation of age, weight, height, and arm subcutaneous fat were 21.5 ± 1.45, 12.6 ± 64.3, 168.7 ± 9.8, 15.3 ± 7, respectively. 17 subjects (12.2%) of the participants in the study have a score of less than 14, and the rest were above 14. Using regression analysis, it was found that exercise and arm subcutaneous fat are predictive variables associated with obtaining a high score in the FMS test. Conclusion: Exercise and weight loss are effective factors for increasing the movement performance of individuals, and this factor is independent of the size of other physical dimensions.

Keywords: functional movement, screening test, anthropometry, ergonomics

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