Search results for: local coronary artery disease

Authors: Sarmiza Stanca, Wolfgang Fritzsche, Christoph Krafft, Jürgen Popp

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Independent of the cell type a thin layer of a few nanometers thickness surrounds the cell interior as the cellular membrane. The transport of ions and molecules through the membrane is achieved in a very precise way by pores. Understanding the process of opening and closing the pores due to an electrochemical gradient across the membrane requires knowledge of the pore constitutive proteins. Recent reports prove the access to the molecular level of the cellular membrane by atomic force microscopy (AFM). This technique also permits an electrochemical study in the immediate vicinity of the tip. Specific molecules can be electrochemically localized in the natural cellular membrane. Our work aims to recognize the protein domains of the pores using an AFM probe as a miniaturized amperometric sensor, and to follow the protein behavior while changing the applied potential. The intensity of the current produced between the surface and the AFM probe is amplified and detected simultaneously with the surface imaging. The AFM probe plays the role of the working electrode and the substrate, a conductive glass on which the cells are grown, represent the counter electrode. For a better control of the electric potential on the probe, a third electrode Ag/AgCl wire is mounted in the circuit as a reference electrode. The working potential is applied between the electrodes with a programmable source and the current intensity in the circuit is recorded with a multimeter. The applied potential considers the overpotential at the electrode surface and the potential drop due to the current flow through the system. The reported method permits a high resolved electrochemical study of the protein domains on the living cell membrane. The amperometric map identifies areas of different current intensities on the pore depending on the applied potential. The reproducibility of this method is limited by the tip shape, the uncontrollable capacitance, which occurs at the apex and a potential local charge separation.

Keywords: AFM, sensor, membrane, pores, proteins

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Authors: A. M. Taleb, A. G. Tail, A. F. Kara, B. B. Djedouani, C. T. Moussa

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Forensic entomology is the use of insects to aid legal investigations. The main purpose of forensic entomology is to establish the postmortem interval (PMI). In order to estimate the PMI, a forensic entomologist compares the case data with certain reference information relevant to the particular location and time of year. This reference information, including the local distribution of species, are not available in Algeria. Therefore, experiments need to be conducted to provide references for entomological evidence. The objective of this study was to identify the necrophagous flies species which arrive first to carrion using liver baits in Ghardaia, South Algeria. The study was carried out during the spring season in the palmeral of Beni Isguen, Ghardaia which is well known by its hot arid climate. The experiment site (32°28’0’’ N, 3°42’0’’ E), is situated at an altitude of about 526 metres above mean sea level. On April the 4th, 2014, a number of three replicates of liver baited traps were placed in the shade and other three baits were exposed to the sun. Flying insects and larvae were captured and identified. After few minutes, flies invaded the traps which were exposed to the sun. In contrast, no flies were observed in the other traps. A total number of fourty five (45) adult specimens belonging to three taxa were identified: Calliphora vicina (Robineau-Desvoidy, 1830) (Diptera, Calliphoridae) (51.11 %), Lucilia sericata (Meigen, 1826) (Diptera, Calliphoridae) (33.33 %) and Sarcophaga africa (Wiedemann, 1824) (Diptera: Sarcophagidae) (15.55 %). Six hundred and three (603) maggots belonging to two taxa were identified: Calliphora vicina (76.28 %) and Lucilia sericata (23.71 %). The data obtained from this study provides baseline information regarding the carrion fauna of this area. It will also form a basis for similar studies in different geographical and climatological regions of Algeria.

Keywords: forensic entomology, liver baits, necrophagous fly, Ghardaia, South Algeria

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Authors: Nimot Opeyemi Wahab

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Poor nutritional status during adolescence is a reflection of inadequate intake of nutrients. This can also be associated with a lack of consumption of diverse food. This study assessed the nutritional status and dietary diversity score (DDS) of in-school adolescents in Ibadan North, North East, and Ibadan South West Local Government Areas (LGA) of Oyo State, Nigeria. A cross-sectional study involving 3,510 in-school adolescents from the three LGA was conducted. Nutrient intake was measured using a validated 24-hour dietary recall, and the anthropometric measurement was also taken. Dietary diversity score (DDS) was assessed using the Individual Dietary Diversity Score (WDDS) of nine food groups. Participants were between 10-19years, and the mean age was 14.76±1.68, 15.32±1.77, and 15.45±1.62 in Ibadan North, Ibadan North East, and Ibadan South West, respectively. About 48% of the participants were male (47.9%), while 52.1% were female. BMI-for-age showed that 92.1%, 5.4%, 2.1%, and 0.4% of the participants were normal, underweight, overweight, and obese, respectively. The mean energy intake (143.193±695.98) of the female respondents was more than that of the male respondents (1406.86±767.41). The macronutrients intake (protein, carbohydrates, fiber, and fats) of the female participants was also found to be more than that of the male participants, with a non-significant difference of 0.336, 0.530, 0.234, and 0.069 (at p< 0.05). Out of all the vitamin intake, only vitamin C was found to be statistically different (p=0.038) at p<0.05 between the male and female respondents. Of all the mineral intake, only phosphorus showed a higher intake (575.20±362.12) among female respondents than the male respondents. The mean DDS of all participants was 4.59±0.939. The majority of the participants, 1183 (80.9%), were within the medium DDS category, 9.9% were low, while 1.5% were in the high category: of which males were 474 (71.5%) and females were 709 (88.6%). Participants from Ibadan North were 941(88.5%), and those from South West were 242(60.5%). A non-significant difference in the mean score of participants from the two locations (p=0.467) was also found. A negative correlation exists between DDS and BMI-for age (-0.11), DDS, and energy intake (-0.46) in Ibadan North and South West LGA. The nutritional status of in-school adolescents was normal, and DDS was within the medium category. Nutrition intervention regarding the consumption of diverse food is necessary among adolescents.

Keywords: nutritional status, dietary diversity, adolescents, nutrient intake

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Authors: Walid Ibrahim, Abdul Kasem, Sudeendra Doddi, Ilaria Giono, Tareq Sabagh, Muhammad Ammar, Nermin Osman

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Background: wire-guided localization (WL) is the most widely used method for the localization of non-palpable breast lesions. SAVI SCOUT occult lesion localization (SSL) is a new technique in breast-conservative surgery. SSL has the potential benefit of improving radiology workflow as well as accurate localization. Purpose: The purpose of this study is to compare the breast tissue specimen volume and weight and margin excision between WL and SSL. Materials and methods: A single institution retrospective analysis of 377 female patients who underwent wide local breast excision with SAVI SCOUT and or wire-guided technique between 2018 and 2021 in a UK University teaching hospital. Breast department. Breast tissue specimen volume and weight, and margin excision have been evaluated in the three groups of different localization. Results: Three hundred and seventy-seven patients were studied. Of these, 261 had wire localization, 88 had SCOUT and 28 had dual localization techniques. Tumor size ranged from 1 to 75mm (Median 20mm). The pathology specimen weight ranged from 1 to 466gm (Median 46.8) and the volume ranged from 1.305 to 1560cm³ (Median 106.32 cm³). SCOUT localization was associated with a significantly low specimen weight than wire or the dual technique localization (Median 41gm vs 47.3gm and 47gm, p = 0.029). SCOUT was not associated with better specimen volume with a borderline significance in comparison to wire and combined techniques (Median 108cm³ vs 105cm³ and 105cm³, p = 0.047). There was a significant correlation between tumor size and pathology specimen weight in the three groups. SCOUT showed a better >2mm safety margin in comparison to the other 2 techniques (p = 0.031). Conclusion: Preoperative SCOUT localization is associated with better specimen weight and better specimen margin. SCOUT did not show any benefits in terms of specimen volume which may be due to difficulty in getting the accurate specimen volume due to the irregularity of the soft tissue specimen.

Keywords: scout, wire, localization, breast

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Authors: Yiseyon Sunday Hosu, Motebang Dominic Vincent Nakin, Elphina N. Cishe

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Universal access to clean and safe drinking water and basic sanitation is one of the targets of the 6th Sustainable Development Goals (SDGs). This paper explores the evidence-based indicators of Water Rights Acts (2013) among households in the rural communities in the Mthatha River catchment of OR Tambo District Municipality of South Africa. Daily access to minimum 25 litres/person and the factors influencing clean water access were investigated in the catchment. A total number of 420 households were surveyed in the upper, peri-urban, lower and coastal regions of Mthatha Rivier catchment. Descriptive and logistic regression analyses were conducted on the data collected from the households to elicit vital information on domestic water security among rural community dwellers. The results show that approximately 68 percent of total households surveyed have access to the required minimum 25 litre/person/day, with 66.3 percent in upper region, 76 per cent in the peri-urban, 1.1 percent in the lower and 2.3 percent in the coastal regions. Only 30 percent among the total surveyed households had access to piped water either in the house or public taps. The logistic regression showed that access to clean water was influenced by lack of water infrastructure, proximity to urban regions, daily flow of pipe-borne water, household size and distance to public taps. This paper recommends that viable integrated rural community-based water infrastructure provision strategies between NGOs and local authority and the promotion of point of use (POU) technologies to enhance better access to clean water.

Keywords: domestic water, household technology, water security, rural community

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Authors: Karan Sharma, Ajay Kumar

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Epileptic seizure is a type of disease due to which electrical charge in the brain flows abruptly resulting in abnormal activity by the subject. One percent of total world population gets epileptic seizure attacks.Due to abrupt flow of charge, EEG (Electroencephalogram) waveforms change. On the display appear a lot of spikes and sharp waves in the EEG signals. Detection of epileptic seizure by using conventional methods is time-consuming. Many methods have been evolved that detect it automatically. The initial part of this paper provides the review of techniques used to detect epileptic seizure automatically. The automatic detection is based on the feature extraction and classification patterns. For better accuracy decomposition of the signal is required before feature extraction. A number of parameters are calculated by the researchers using different techniques e.g. approximate entropy, sample entropy, Fuzzy approximate entropy, intrinsic mode function, cross-correlation etc. to discriminate between a normal signal & an epileptic seizure signal.The main objective of this review paper is to present the variations in the EEG signals at both stages (i) Interictal (recording between the epileptic seizure attacks). (ii) Ictal (recording during the epileptic seizure), using most appropriate methods of analysis to provide better healthcare diagnosis. This research paper then investigates the effects of a noninvasive healing therapy on the subjects by studying the EEG signals using latest signal processing techniques. The study has been conducted with Reiki as a healing technique, beneficial for restoring balance in cases of body mind alterations associated with an epileptic seizure. Reiki is practiced around the world and is recommended for different health services as a treatment approach. Reiki is an energy medicine, specifically a biofield therapy developed in Japan in the early 20th century. It is a system involving the laying on of hands, to stimulate the body’s natural energetic system. Earlier studies have shown an apparent connection between Reiki and the autonomous nervous system. The Reiki sessions are applied by an experienced therapist. EEG signals are measured at baseline, during session and post intervention to bring about effective epileptic seizure control or its elimination altogether.

Keywords: EEG signal, Reiki, time consuming, epileptic seizure

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Authors: Mustafa M. Donma, Ayşen Haksayar, Bahadır Batar, Buse Tepe, Birol Topçu, Orkide Donma

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Childhood obesity is an ever-increasing health problem. The Association of obesity with severe chronic diseases such as diabetes and cardiovascular diseases makes the problem life-threatening. Aside from psychological, societal and metabolic factors, genetic polymorphisms have gained importance concerning etiology in recent years. The aim of this study was to evaluate the relationship between rs10455872 gene polymorphism in the Lipoprotein (a) locus and the development of childhood obesity. This was a prospective study carried out according to the Helsinki Declarations. The study protocol was approved by the Institutional Ethics Committee. This study was supported by Tekirdag Namik Kemal University Rectorate, Scientific Research Projects Coordination Unit. Project No: NKUBAP.02.TU.20.278. A total of 180 children (103 obese (OB) and 77 healthy), aged 6-18 years, without any acute or chronic disease, participated in the study. Two different groups were created: OB and healthy control. Each group was divided into two further groups depending on the nature of the polymorphism. Anthropometric measurements were taken during the detailed physical examination. Laboratory tests and TANITA measurements were performed. For the statistical evaluations, SPSS version 28.0 was used. A P-value smaller than 0.05 was the statistical significance degree. The distribution of lipoprotein (a) rs10455872 gene polymorphism did not differ between OB and healthy children. Children with AG genotype in both OB and control groups had lower body mass index (BMI), diagnostic obesity notation model assessment index (DONMA II), body fat ratio (BFR), C-reactive protein (CRP), and metabolic syndrome index (MetS index) values compared to children with normal AA genotype. In the OB group, serum iron, vitamin B12, hemoglobin, MCV, and MCH values were found to be higher in the AG genotype group than those of children with the normal AA genotype. A significant correlation was found between the MetS index and BFR among OB children with normal homozygous genotype. MetS index increased as BFR increased in this group. However, such a correlation was not observed in the OB group with heterozygous AG genotype. To the best of our knowledge, the association of lipoprotein (a) rs10455872 gene polymorphism with the etiology of childhood obesity has not been studied yet. Therefore, this study was the first report suggesting polymorphism with AG genotype as a good risk factor for obesity.

Keywords: child, gene polymorphism, lipoprotein (a), obesity, rs10455872

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Authors: Yui Okuno, Mariko Era, Takayoshi Kawahara, Takahide Kanyama, Hiroshi Morita

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Introduction: Fungus and mite are known as allergens that cause an allergic disease for example asthma bronchiale and allergic rhinitis. Cladosporium cladosporioides is one of the most often detected fungi in the indoor environment and causes pollution and deterioration. Dermatophagoides farinae is major mite allergens indoors. Therefore, the creation of antifungal agents with high safety and the antifungal effect is required. Fatty acid salts are known that have antibacterial activities. This report describes the effects of fatty acid salts against Cladosporium cladosporioides NBRC 30314 and Dermatophagoides farinae. Methods: Potassium salts of 9 fatty acids (C4:0, C6:0, C8:0, C10:0, C12:0, C14:0, C18:1, C18:2, C18:3) were prepared by mixing the fatty acid with the appropriate amount of KOH solution to a concentration of 175 mM and pH 10.5. The antifungal method, the spore suspension (3.0×104 spores/mL) was mixed with a sample of fatty acid potassium (final concentration of 175 mM). Samples were counted at 0, 10, 60, 180 min by plating (100 µL) on PDA. Fungal colonies were counted after incubation for 3 days at 30 °C. The MIC (minimum inhibitory concentration) against the fungi was determined by the two-fold dilution method. Each fatty acid salts were inoculated separately with 400 µL of C. cladosporioides at 3.0 × 104 spores/mL. The mixtures were incubated at the respective temperature for each organism for 10 min. The tubes were then contacted with the fungi incubated at 30 °C for 7 days and examined for growth of spores on PDA. The acaricidal method, twenty D. farinae adult females were used and each adult was covered completely with 2 µL fatty acid potassium for 1 min. The adults were then dried with filter paper. The filter paper was folded and fixed by two clips and kept at 25 °C and 64 % RH. Mortalities were determained 48 h after treatment under the microscope. D. farina was considered to be dead if appendages did not move when prodded with a pin. Results and Conclusions: The results show that C8K, C10K, C12K, C14K was effective to decrease survival rate (4 log unit) of the fatty acids potassium incubated time for 10 min against C. cladosporioides. C18:3K was effective to decrease 4 log unit of the fatty acids potassium incubated time for 60 min. Especially, C12K was the highest antifungal activity and the MIC of C12K was 0.7 mM. On the other hand, the fatty acids potassium showed no acaricidal effects against D. farinae. The activity of D. farinae was not adversely affected after 48 hours. These results indicate that C12K has high antifungal activity against C. cladosporioides and suggest the fatty acid potassium will be used as an antifungal agent.

Keywords: fatty acid salts, antifungal effects, acaricidal effects, Cladosporium cladosporioides, Dermatophagoides farinae

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Authors: Rolland Epafras Fanggidae

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The impact of climate change such as natural disasters, crop failures, increasing crop pests, bad gisi on children and other impacts, will indirectly affect education, health, food safety, as well as the economy. The impact of climate change has put a man in a situation of vulnerability, which was powerless to meet the minimum requirements, it is in close contact with poverty. When talking about poverty, the most plausible is female. The role of women in Indonesia, particularly in East Nusa Tenggara in Domestic aktifity very central and dominant. This makes Indonesian woman can say "outstanding actor in the face of climate change mitigation and adaptation and applying local knowledge", but still ignored when women based on gender division of work entrusted role in domestic activities. Similarly, in public activity is an extension of the Domestic example, trading activity in the market lele / mama. Although men are also affected by climate change, but most feel is female. From the above problems, it can be said that Indonesia's commitment has not been followed by optimal empowerment of women's role in addressing climate change, it is necessary to learn to know how the role of women in the face of climate change impacts that hit on her role as a woman, a housewife or head of the family and will be input in order to determine how women find a solution to tackle the problem of climate change. This study focuses on the efforts made by women cope with the impacts of climate change, efforts by the government, empowerment model used in Playing the impact of climate change. The container with the formulation of the title "The Role of Women in Climate Change Impact in Kupang district". Where the assessment in use types Research mix Methods combination of quantitative research and qualitative research. While the location of the research conducted in Kupang regency, East Nusa Tenggara, namely: District of East Kupang is a district granary in Kupang district. Subdistrict West Kupang, especially Tablolong Village is the center of seaweed cultivation in Kupang district.

Keywords: climate change, women, women's roles, gender, family

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Authors: A. P. Pashkov

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The number of environmental factors that adversely affect children's health is growing every year; their combination in each territory is different. The contribution of socio-economic factors to the health status of the younger generation is increasing. It is the child’s body that is most sensitive to changes in environmental conditions, responding to this with a deterioration in health. Over the past years, scientists have determined the influence of environmental factors and the incidence of children. Currently, there is a tendency to study regional characteristics of the interaction of a combination of environmental factors with the child's body. The aim of the work was to identify trends in the primary non-infectious morbidity of the children of the Altai Territory as a unique region that combines territories with different levels of environmental quality indicators, as well as to assess the effect of atmospheric air, drinking water and socio-economic indicators on the incidence of children in the region. An unfavorable tendency has been revealed in the region for incidence of such nosological groups as neoplasms, including malignant ones, diseases of the endocrine system, including obesity and thyroid disease, diseases of the circulatory system, digestive diseases, diseases of the genitourinary system, congenital anomalies, and respiratory diseases. Between some groups of diseases revealed a pattern of geographical distribution during mapping and a significant correlation. Some nosologies have a relationship with socio-economic indicators for an integrated assessment: circulatory system diseases, respiratory diseases (direct connection), endocrine system diseases, eating disorders, and metabolic disorders (feedback). The analysis of associations of the incidence of children with average annual concentrations of substances that pollute the air and drinking water showed the existence of reliable correlation in areas of critical and intense degree of environmental quality. This fact confirms that the population living in contaminated areas is subject to the negative influence of environmental factors, which immediately affects the health status of children. The results obtained indicate the need for a detailed assessment of the influence of environmental factors on the incidence of children in the regional aspect, the formation of a database, and the development of automated programs that can predict the incidence in each specific territory. This will increase the effectiveness, including economic of preventive measures.

Keywords: incidence of children, regional features, socio-economic factors, environmental factors

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Authors: Kishor T. Zingre, Seshadhri Srinivasan

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Energy consumption by the building sector is increasing at an alarming rate throughout the world and leading to more building-related CO₂ emissions into the environment. In buildings, the main contributors to energy consumption are heating, ventilation, and air-conditioning (HVAC) systems, lighting, and electrical appliances. It is hypothesised that the energy efficiency in buildings can be achieved by implementing sustainable technologies such as i) enhancing the thermal resistance of fabric materials for reducing heat gain (in hotter climates) and heat loss (in colder climates), ii) enhancing daylight and lighting system, iii) HVAC system and iv) occupant localization. Energy performance of various sustainable technologies is highly dependent on climatic conditions. This paper investigated the use of machine learning techniques for accurate prediction of air-conditioning energy in seasonal climates. The data required to train the machine learning techniques is obtained using the computational simulations performed on a 3-story commercial building using EnergyPlus program plugged-in with OpenStudio and Google SketchUp. The EnergyPlus model was calibrated against experimental measurements of surface temperatures and heat flux prior to employing for the simulations. It has been observed from the simulations that the performance of sustainable fabric materials (for walls, roof, and windows) such as phase change materials, insulation, cool roof, etc. vary with the climate conditions. Various renewable technologies were also used for the building flat roofs in various climates to investigate the potential for electricity generation. It has been observed that the proposed technique overcomes the shortcomings of existing approaches, such as local linearization or over-simplifying assumptions. In addition, the proposed method can be used for real-time estimation of building air-conditioning energy.

Keywords: building energy efficiency, energyplus, machine learning techniques, seasonal climates

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Authors: Jonathan Gong

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Purpose AI-driven solutions are at the forefront of many pathology and medical imaging methods. Using algorithms designed to better the experience of medical professionals within their respective fields, the efficiency and accuracy of diagnosis can improve. In particular, X-rays are a fast and relatively inexpensive test that can diagnose diseases. In recent years, X-rays have not been widely used to detect and diagnose COVID-19. The under use of Xrays is mainly due to the low diagnostic accuracy and confounding with pneumonia, another respiratory disease. However, research in this field has expressed a possibility that artificial neural networks can successfully diagnose COVID-19 with high accuracy. Models and Data The dataset used is the COVID-19 Radiography Database. This dataset includes images and masks of chest X-rays under the labels of COVID-19, normal, and pneumonia. The classification model developed uses an autoencoder and a pre-trained convolutional neural network (DenseNet201) to provide transfer learning to the model. The model then uses a deep neural network to finalize the feature extraction and predict the diagnosis for the input image. This model was trained on 4035 images and validated on 807 separate images from the ones used for training. The images used to train the classification model include an important feature: the pictures are cropped beforehand to eliminate distractions when training the model. The image segmentation model uses an improved U-Net architecture. This model is used to extract the lung mask from the chest X-ray image. The model is trained on 8577 images and validated on a validation split of 20%. These models are calculated using the external dataset for validation. The models’ accuracy, precision, recall, f1-score, IOU, and loss are calculated. Results The classification model achieved an accuracy of 97.65% and a loss of 0.1234 when differentiating COVID19-infected, pneumonia-infected, and normal lung X-rays. The segmentation model achieved an accuracy of 97.31% and an IOU of 0.928. Conclusion The models proposed can detect COVID-19, pneumonia, and normal lungs with high accuracy and derive the lung mask from a chest X-ray with similarly high accuracy. The hope is for these models to elevate the experience of medical professionals and provide insight into the future of the methods used.

Keywords: artificial intelligence, convolutional neural networks, deep learning, image processing, machine learning

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Authors: Seember Susan Aondoakura

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This paper examines the international legal framework established to address the challenges women and girls experience in situations of violent conflict. The United Nations (UN) women, peace, and security agenda (hereafter WPS agenda, the Agenda) aspire to make wars safer for women. It recognizes women's agency in armed conflict and their victimization and formulates measures for their protection. The Agenda also acknowledges women's participation in conflict transformation and post-conflict reconstruction. It also calls for the involvement of women in conflict transformation, encourages the protection of women from sex and gender-based violence (SGBV), and provides relief and recovery from conflict-related SGBV. Using Third World Critical Feminist Theory, this paper argues that the WPS agenda overly focus on the protection of women from SGBV occurring in the less developed and conflict-ridden states in the global south, obscures the complicity of western states and economies to the problem, and silences the privileges that such states derive from war economies that continue to fuel conflict. This protectionist approach of the UN also obliterates other equally pressing problems in need of attention, like the high rates of economic degradation in conflict-ravaged societies of the global south. Prioritising protection also 'others' the problem, obliterating any sense of interconnections across geographical locations and situating women in the less developed economies of the global south as the victims and their men as the perpetrators. Prioritising protection ultimately situates western societies as saviours of Third World women with no recourse to their role in engendering and sustaining war. The paper demonstrates that this saviour mentality obliterates chances of any meaningful coalition between the local and the international in framing and addressing the issue, as solutions are formulated from a specific lens—the white hegemonic lens.

Keywords: conflict, protection, security, SGBV

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Authors: Mae C. Pavilario

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This study employs a sequential explanatory mixed method. Quantitatively it investigated the profile of grade VII students. Qualitatively, the prevailing contextual variables that affect their frustration-level were sought based on their perspective and that of their parents and teachers. These students were categorized as frustration-level in reading based on the data on word list of the Philippine Informal Reading Inventory (Phil-IRI). The researcher-made reading factor instrument translated to local dialect (Hiligaynon) was subjected to cross-cultural translation to address content, semantic, technical, criterion, or conceptual equivalence, the open-ended questions, and one unstructured interview was utilized. In the profile of the 26 participants, the 12 males are categorized as grade II and grade III frustration-levels. The prevailing contextual variables are personal-“having no interest in reading”, “being ashamed and fear of having to read in front of others” for extremely high frustration level; social environmental-“having no regular reading schedule at home” for very high frustration level and personal- “having no interest in reading” for high frustration level. Kendall Tau inferential statistical tool was used to test the significant relationship in the prevailing contextual variables that affect frustration-level readers when grouped according to perspective. Result showed that significant relationship exists between students-parents perspectives; however, there is no significant relationship between students’ and teachers’, and parents’ and teachers’ perspectives. The themes in the narratives of the participants on frustration-level readers are existence of speech defects, undesirable attitude, insufficient amount of reading materials, lack of close supervision from parents, and losing time and focus on task. Intervention was designed.

Keywords: contextual variables, frustration-level readers, perspective, inquiry

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Authors: Ioanna Skoufali

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The present study is directed towards adaptation to climate change closely related to the phenomenon of the urban heat island (UHI). This issue is widespread and common to different urban realities, but particularly in Mediterranean cities that are characterized by dense urban. The attention of this work of redevelopment of the open space is focused on mitigation techniques aiming to solve local problems such as microclimatic parameters and the conditions of thermal comfort in summer, related to urban morphology. This quantitative analysis, evaluation, and verification survey involves the methodological elaboration applied in a real study case by Serres, through the experimental support of the ENVImet Pro V4.1 and BioMet software developed: i) in two phases concerning the anteoperam (phase a1 # 2013) and the post-operam (phase a2 # 2016); ii) in scenario A (+ 25% of green # 2017). The first study tends to identify the main intervention strategies, namely: the application of cool pavements, the increase of green surfaces, the creation of water surface and external fans; moreover, it obtains the minimum results achieved by the National Program 'Bioclimatic improvement project for public open space', EPPERAA (ESPA 2007-2013) related to the four environmental parameters illustrated below: the TAir = 1.5 o C, the TSurface = 6.5 o C, CDH = 30% and PET = 20%. In addition, the second study proposes a greater potential for improvement than postoperam intervention by increasing the vegetation within the district towards the SW/SE. The final objective of this in-depth design is to be transferable in homogeneous cases of urban regeneration processes with obvious effects on the efficiency of microclimatic mitigation and thermal comfort.

Keywords: cool pavements, microclimate parameters (TAir, Tsurface, Tmrt, CDH), mitigation strategies, outdoor thermal comfort (PET & UTCI)

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Authors: Conchita Martin de Bustamante, Christopher S. Kung, Brianne Lacy, Eunsol Park, Hien Piotrowski, Mustafa Husain, Waseem Ahmed

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Objective: To explore the comorbidity of mental health conditions (major depressive disorder, borderline personality disorder, generalized anxiety disorder, and schizophrenia) with opioid use disorder in people incarcerated at a large urban jail. Background Schizophrenia, depression, bipolar disorder, and anxiety are all serious mental health conditions that are highly prevalent amongst incarcerated patients. However, it is seldom the only disorder these patients are suffering from. According to the US Department of Justice, about half of US prisoners, both at the state and federal level, suffer from substance use disorders. Although the opioid epidemic has been studied greatly in the recent years amongst the general population, little has been explored on how the opioid crisis has affected incarcerated patients in local jails, particularly regarding which of these patients are most susceptible. Method The cohort consisted of 507 people incarcerated at a large county jail who were evaluated by mental health providers in December 2020. A retrospective review was performed to evaluate associations between mental health diagnoses, substance use disorder, and other demographic variables. Results Participants had been diagnosed with various mental health conditions, including MDD (22.6%, n = 115), GAD (33.7%, n = 171), Schizophrenia (15.2%, n = 77) and BPD (27%, n = 137). Preliminary Chi square tests were conducted for these conditions against marijuana, alcohol, cocaine, opioid, methamphetamine, benzodiazepines, and sedative use disorders. The results showed significant associations between Schizophrenia (p = 0.013), GAD (p M 0.001), and MDD (p = 0.029) with opioid use disorders. Conclusions Determining the extent of these comorbid substance use and mental health disorders within an incarcerated population can help influence treatment plans for future incarcerated patients. Many federal and state jail systems lack pharmacological substance use intervention and the prevalence of these co-morbid conditions can shed light on the importance of treating conditions concurrently upon intake.

Keywords: mental health conditions, opioids, substance use disorder, comorbidity

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Authors: Yue Wang, Fan Chen

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After the economic reform in 1978, the urbanization in China has grown fast. It urged cities to expand in an unprecedented high speed. Villages around were annexed unprepared, and it turned out to be a new type of community called 'village in city.' Two things happened here. First, the locals gave up farming and turned to secondary industry and tertiary industry, as a result of losing their land. Secondly, attracted by the high income in cities and low rent here, plenty of migrants came into the community. This area is important to a city in rapid growth for providing a transitional zone. But thanks to its passivity and low development, 'village in city' has caused lots of trouble to the city. Densities of population and construction are both high, while facilities are severely inadequate. Unplanned and illegal structures are built, which creates a complex mixed-function area and leads to a bad residential area. Besides, the locals have a strong property right consciousness for the land. It holds back the transformation and development of the community. Although the land capitalization can bring significant benefits, it’s inappropriate to make a great financial compensation to the locals, and considering the large population of city migrants, it’s important to explore the relationship among the 'village in city,' city immigrants and the city itself. Taking the example of Hangzhou, this paper analyzed the developing process, functions spatial distribution, industrial structure and current traffic system of 'village in city.' Above the research on the community, this paper put forward a common method to make urban planning through the following ways: adding city functions, building civil facilities, re-planning functions spatial distribution, changing the constitution of local industry and planning new traffic system. Under this plan, 'village in city' finally can be absorbed into cities and make its own contribution to the urbanization.

Keywords: China, city immigrant, urbanization, village in city

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Authors: Wijayanada Rupasinghe, A. H. Dinithi Jayasekara

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In a modern democracy, new media can be used by governments to involve citizens in decision-making, and by civil society to engage people in specific issues. However new media can also be used to broaden political participation by helping citizens to communicate with their representatives and with each other. Arguably this political communication is most important during election campaigns when political parties and candidates seek to mobilize citizens and persuade them to vote for a given party or candidate. The new media must be used by Parliaments, Parliamentarians, governments and political parties as they are highly effective tools to involve and inform citizens in public policymaking and in the formation of governments. But all these groups must develop strategies to deal with a wide array of both positive and negative effects of these rapidly growing media.New media has begun to take precedent over other communication outlets in part because of its heightened accessibility and usability. Using personal website can empower the public in a way that is far faster, cheaper and more pervasive than other forms of communication. They encourage pluralism, reach young people more than other media and encourage greater participation, accountability and transparency. This research discusses the impact politicians’ personal websites has over their overall electability and likability and explores the integration of website is an essential campaign tactic on both the local and national level. This research examined the impact of having personal website have over the way constituents view politicians. This research examined how politicians can use their website in the most effective fashion and incorporate these new media outlets as essential campaign tools and tactics. A mixed-method approach using content analysis. Content analysis selected thirty websites in sri Lankan politicians. Research revealed that politician’s new media usage significantly influenced and enriched the experience an individual has with the public figure.

Keywords: election campaign ministers, new media, parliament, politicians websites

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Authors: Anahita Suri

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Craft -an integral part of the conduit to create something beautiful- is a visual representation of the human imagination given life through the hand. The Mirgan tribe in the Naxalite infested forests of Koraput, Odisha are not exempt from this craving for beauty. These skilled craftsmen dye and weave the simple yet sophisticated Kotpad textiles. The women undertake the time-consuming task of dyeing the cotton and silk yarns with the root of the aul tree. The men then weave these yarns into beautiful sarees and dupattas. The root of the aul tree lends the textile its maroon to brown color, which is offset against the unbleached cotton to create a minimalist and distinctive look. The motifs, incorporated through the extra weft technique, reflect the rich tribal heritage of the community. This is an eco-friendly, non-toxic textile. Kotpad fabrics were on the verge of extinction due to various factors like poor infrastructure, no innovation in traditional designs/products, customer ignorance leading to low demand. With livelihood opportunities through craft slowly dwindling, artisans were moving to alternative sources of income generation, like agriculture and daily wage labor. There was an urgent need for intervention to revive the craft, spread awareness about them in urban spaces, and strengthen the artisan’s ability to innovate and create. Recent efforts by government bodies and local designers have given Kotpad handloom a contemporary look without diluting its essence. This research explores the possibilities to leverage Kotpad handloom to find a place in the dynamic culture of the world by its promotion among different target groups and incorporating self-sustaining practices for the artisans. This could further encourage a space for handmade and handcrafted art, rich with stories about India, with a contemporary visual sensibility. This will strengthen environmental and ethical sustainability.

Keywords: craft, contemporary, handloom, natural dye, tribal

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Authors: Ahmed Auda, Manjree Agarwala, Giles Hardya, Yonglin Rena

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Botrytis cinerea is a major pest for many plants. It can attack a wide range of plant parts. It can attack buds, flowers, and leaves, stems, and fruit. However, B. cinerea can be mixed with other diseases that cause the same damage. There are many species of botrytis and more than one different strains of each. Botrytis might infect the foliage of nursery stock stored through winter in damp conditions. There are no known resistant plants. Botrytis must have nutrients or food source before it infests the plant. Nutrients leaking from wounded plant parts or dying tissue like old flower petals give the required nutrients. From this food, the fungus becomes more attackers and invades healthy tissue. Dark to light brown rot forms in the ill tissue. High humidity conditions support the growth of this fungus. However, we suppose that selection pressure can act on the morphological and neurophysiologic filter properties of the receiver and on both the biochemical and the physiological regulation of the signal. Communication is implied when signal and receiver evolves toward more and more specific matching, culminating. In other hand, receivers respond to portions of a body odor bouquet which is released to the environment not as an (intentional) signal but as an unavoidable consequence of metabolic activity or tissue damage. Each year Botrytis species can cause considerable economic losses to plant crops. Even with the application of strict quarantine and control measures, these fungi can still find their way into crops and cause the imposition of onerous restrictions on exports. Blueberry fruit mould caused by a fungal infection usually results in major losses during post-harvest storage. Therefore, the management of infection in early stages of disease development is necessary to minimize losses. The overall purpose of this study will develop sensitive, cheap, quick and robust diagnostic techniques for the detection of B. cinerea in blueberry. The specific aim was designed to investigate the performance of volatile organic compounds (VOCs) in the detection and discrimination of blueberry fruits infected by fungal pathogens with an emphasis on Botrytis in the early storage stage of post-harvest.

Keywords: botrytis cinerea, blueberry, GC/MS, VOCs

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Authors: A. Dean, M. Pitcher, L. Storer, K. Shanahan, I. Rio, B. Mann

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Purpose: Breast cancer survivors are at risk of specific physical and psycho-social issues, such as arm swelling, fatigue, and depression. Firstly, we investigate symptoms reported by Australia breast cancer survivors upon completion of definitive treatment. Secondly, we evaluate the appropriateness and effectiveness of a multi-centre pilot program nurse-led clinic to identify these issues and make timely referrals to available services. Methods: Patients post-definitive treatment (excluding ongoing hormonal therapy) for early breast cancer or ductal carcinoma in situ were invited to participate. An hour long appointment with a breast care nurse (BCN) was scheduled. In preparation, patients completed validated quality-of-life surveys (FACT-B, Menopause Rating Scale, Distress Thermometer). During the appointment, issues identified in the surveys were addressed and referrals to appropriate services arranged. Results: 183 of 274 (67%) eligible patients attended a nurse-led clinic. Mean age 56.8 years (range 29-87 years), 181/183 women, 105/183 post-menopausal. 96 (55%) participants reported significant level of distress; 31 (18%) participants reported extreme distress or depression. Distress stemmed from a lack of energy (56/175); poor quality of sleep (50/176); inability to work or participate in household activities (35/172) and problems with sex life (28/89). 166 referrals were offered; 94% of patients accepted the referrals. 65% responded to a follow-up survey: the majority of women either strongly agreed or agreed that the BCN was overwhelmingly supportive, helpful in making referrals, and compassionate towards them. 39% reported making lifestyle changes as a result of the BCN. Conclusion: Breast cancer survivors experience a unique set of challenges, including low mood, difficulty sleeping, problems with sex life and fear of disease recurrence. The nurse-led clinic model is an appropriate and effective method to ensure physical and psycho-social issues are identified and managed in a timely manner. This model empowers breast cancer survivors with information about their diagnosis and available services.

Keywords: early breast cancer, survivorship, breast care nursing, oncology nursing and cancer care

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Authors: Busra Ekinci

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Urban heat island term becomes one of the most important problem in urban areas as a reflection of global warming in local scale last years. Many communities and governments are taking action to reduce heat island effects on urban areas where the half of the world's population live today. At this point, urban design turned out to be an important practice and research area for providing an environmentally sensitive urban development. In this study, mitigating strategies of urban heat island effects by urban design are investigated in Aksaray Square and surroundings in Istanbul. Aksaray is an important historical and commercial center of Istanbul, which has an increasing density due to be the node of urban transportation. Also, Istanbul Metropolitan Municipality prepared an urban design project to respond the needs of growing population in the area for 2018. The purpose of the study is emphasizing the importance of urban design objectives and strategies that are developed to reduce the heat island effects on urban areas. Depending on this, the urban heat island effect of the area was examined based on the albedo (reflectivity) parameter which is the most effective parameter in the formation of the heat island effect in urban areas. Albedo values were calculated by Albedo Viewer web application model that was developed by Energy and Environmental Engineering Department of Kyushu University in Japan. Albedo parameter had examined for the present situation and the planned situation with urban design project. The results show that, the current area has urban heat island potential. With the Aksaray Square Project, the heat island effect on the area can be reduced, but would not be completely prevented. Therefore, urban design strategies had been developed to reduce the island effect in addition to the urban design project of the area. This study proves that urban design objectives and strategies are quite effective to reduce the heat island effects, which negatively affect the social environment and quality of life in urban areas.

Keywords: Albedo, urban design, urban heat island, sustainable design

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Authors: Gloria Patricia Manurung

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Jakarta Bus Rapid Transit (BRT) system which was established in 2009 to reduce private vehicle usage and ease the rush hour gridlock throughout the Jakarta Greater area, has failed to achieve its purpose. With gradually increasing the number of private vehicles ownership and reduced road space by the BRT lane construction, private vehicle users intuitively invade the exclusive lane of BRT, creating local traffic along the BRT network. Invaded BRT lanes costs become the same with the road network, making BRT which is supposed to be the main public transportation in the city becoming unreliable. Efforts to guard critical lanes with preventing the invasion by allocating traffic agents at several intersections have been expended, lead to the improving congestion level along the lane. Given a set of number of traffic agents, this study uses an analytical approach to finding the best deployment strategy of traffic agent on a simplified Jakarta road network in minimizing the BRT link cost which is expected to lead to the improvement of BRT system time reliability. User-equilibrium model of traffic assignment is used to reproduce the origin-destination demand flow on the network and the optimum solution conventionally can be obtained with brute force algorithm. This method’s main constraint is that traffic assignment simulation time escalates exponentially with the increase of set of agent’s number and network size. Our proposed metaheuristic and heuristic algorithms perform linear simulation time increase and result in minimized BRT cost approaching to brute force algorithm optimization. Further analysis of the overall network link cost should be performed to see the impact of traffic agent deployment to the network system.

Keywords: traffic assignment, user equilibrium, greedy algorithm, optimization

Procedia PDF Downloads 229

Authors: Geliashvili T. M., Tyulyandina A. S., Valiev A. K., Kononets P. V., Kharatishvili T. K., Salkov A. G., Pronin A. I., Gadzhieva E. H., Parnas A. V., Ilyakov V. S.

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Aim/Introduction: Metastasis (Mts) to the sternum, while extremely rare in differentiated thyroid cancer (DTC) (1), requires a personalized, multidisciplinary treatment approach. In aggressively growing Mts to the sternum, which rapidly become unresectable, a comprehensive therapeutic and diagnostic approach is particularly important. Materials and methods: We present a clinical case of solitary Mts to the sternum as first manifestation of a papillary thyroid microcarcinoma in a 55-year-old man. Results: 18F-FDG PET/CT after thyroidectomy confirmed the solitary Mts to the sternum with extremely high FDG uptake (SUVmax=71,1), which predicted its radioiodine-refractory (RIR). Due to close attachment to the mediastinum and rapid growth, Mts was considered unresectable. During the next three months, the patient received targeted therapy with the tyrosine kinase inhibitor (TKI) Lenvatinib 24 mg per day. 1st course of radioiodine therapy (RIT) 6 GBq was also performed, the results of which confirmed the RIR of the tumor process. As a result of systemic therapy (targeted therapy combined with RIT and suppressive hormone therapy with L-thyroxine), there was a significant biochemical response (decrease of serum thyroglobulin level from 50,000 ng/ml to 550 ng/ml) and a partial response with decrease of tumor size (from 80x69x123 mm to 65x50x112 mm) and decrease of FDG accumulation (SUVmax from 71.1 to 63). All of this made possible to perform surgical treatment of Mts - sternal extirpation with its replacement by an individual titanium implant. At the control examination, the stimulated thyroglobulin level was only 134 ng/ml, and PET/CT revealed postoperative areas of 18F-FDG metabolism in the removed sternal Mts. Also, 18F-FDG PET/CT in the early (metabolic) stage revealed two new bone Mts (in the area of L3 SUVmax=17,32 and right iliac bone SUVmax=13,73), which, as well as the removed sternal Mts, appeared to be RIRs at the 2nd course of RIT 6 GBq. Subsequently, on 02.2022, external beam radiation therapy (EBRT) was performed on the newly identified oligometastatic bone foci. At present, the patient is under dynamic monitoring and in the process of suppressive hormone therapy with L-thyroxine. Conclusion: Thus, only due to the early prescription of targeted TKI therapy was it possible to perform surgical resection of Mts to the sternum, thereby improve the patient's quality of life and preserve the possibility of radical treatment in case of oligometastatic disease progression.

Keywords: differentiated thyroid cancer, metastasis to the sternum, radioiodine therapy, radioiodine-refractory cancer, targeted therapy, lenvatinib

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Authors: Moloud Torkandam

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Any cities must be designed and built in a way that minimizes their need for fossil fuel. Undoubtedly, the necessity of accepting this principle in the previous eras is undeniable with respect to the mode of constructions. Perhaps only due to the great diversity of materials and new technologies in the contemporary era, such a principle in buildings has been forgotten. The question of optimizing energy consumption in buildings has attracted a great deal of attention in many countries and, in this way, they have been able to cut down the consumption of energy up to 30 percent. The energy consumption is remarkably higher than global standards in our country, and the most important reason is the undesirable state of buildings from the standpoint of energy consumption. In addition to providing the means to protect the natural and fuel resources for the future generations, reducing the use of fossil energies may also bring about desirable outcomes such as the decrease in greenhouse gases (whose emissions cause global warming, the melting of polar ice, the rise in sea level and the climatic changes of the planet earth), the decrease in the destructive effects of contamination in residential complexes and especially urban environments and preparation for national self-sufficiency and the country’s independence and preserving national capitals. This research realize that in this modern day and age, living sustainably is a pre-requisite for ensuring a bright future and high quality of life. In acquiring this living standard, we will maintain the functions and ability of our environment to serve and sustain our livelihoods. Electricity is now an integral part of modern life, a basic necessity. In the provision of electricity, we are committed to respecting the environment by reducing the use of fossil fuels through the use of proven technologies that use local renewable and natural resources as its energy source. As far as this research concerned it is completely necessary to work on different type of energy producing such as solar and CPVT system.

Keywords: energy, photovoltaic, termal system, solar energy, CPVT

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Authors: Sitarrine Thongpussawal, Dasarath Jayasuriya, Thanaroj Woraratprasert, Sakawtree Prajamwong

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Thailand grapples with recurrent floods causing substantial repercussions on its economy, society, and environment. In 2021, the economic toll of these floods amounted to an estimated 53,282 million baht, primarily impacting the agricultural sector. The existing flood monitoring system in Thailand suffers from inaccuracies and insufficient information, resulting in delayed warnings and ineffective communication to the public. The Office of the National Water Resources (OWNR) is tasked with developing and integrating data and information systems for efficient water resources management, yet faces challenges in monitoring accuracy, forecasting, and timely warnings. This study endeavors to evaluate the viability of enhancing Thailand's Flood Forecasting and Warning (FFW) systems. Additionally, it aims to formulate a comprehensive work package grounded in international best practices to enhance the country's FFW systems. Employing qualitative research methodologies, the study conducted in-depth interviews and focus groups with pertinent agencies. Data analysis involved techniques like note-taking and document analysis. The study substantiates the feasibility of developing and enhancing FFW systems in Thailand. Implementation of international best practices can augment the precision of flood forecasting and warning systems, empowering local agencies and residents in high-risk areas to prepare proactively, thereby minimizing the adverse impact of floods on lives and property. This research underscores that Thailand can feasibly advance its FFW systems by adopting international best practices, enhancing accuracy, and improving preparedness. Consequently, the study enriches the theoretical understanding of flood forecasting and warning systems and furnishes valuable recommendations for their enhancement in Thailand.

Keywords: flooding, forecasting, warning, monitoring, communication, Thailand

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Authors: Portia Muehlbauer

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This paper examines the evolving landscape of preventing and countering violent extremism (PCVE) by delving into the growing importance of integrating human rights principles into violence prevention strategies on the local, community level. This study sheds light on the underlying theoretical frameworks of violent extremism and the influence of gender while investigating the intersection between human rights preservation and violent extremism prevention. To gain practical insight, the research focuses on two prominent international non-governmental organizations, Women without Borders (WwB) and Hedayah, and their distinct PCVE initiatives. WwB adopts a gender-sensitive approach, implementing parental education programs that empower mothers in at-risk communities to prevent the spread of violent extremism. In contrast, Hedayah takes an indirect route, employing capacity building programs that enhance the capabilities of educators, social workers, and psychologists in early intervention, rehabilitation and reintegration efforts. Qualitative data for this comparative analysis was collected through an extensive four-month internship at WwB during the fall of 2020, a three-month internship at Hedayah in the spring of 2021, a thought-provoking semi-structured interview with the executive director of WwB, personal field notes, and a comprehensive discourse analysis of the prevailing literature on human rights considerations in PCVE practices. This study examines the merits and challenges of integrating human rights into PCVE programming through the lens of both organizations, WwB and Hedayah. The findings of this study will inform policymakers, practitioners, and researchers on the intricate relationship between human rights protection and effective PCVE strategies.

Keywords: preventing and countering violent extremism, human rights, counterterrorism, peacebuilding, capacity building programs, gender studies

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Authors: Lee Rui, Rajeev Ramachandran

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The approach to recurrent fevers in the paediatric or adolescent age group is not a straightforward one. Causes range from infectious diseases to rheumatological conditions to endocrinopathies, and are usually accompanied by weight loss rather than weight gain. We present an interesting case of a 16-year-old girl brought by her mother to the General Pediatrics Clinic for concerns of recurrent fever paired with significant weight gain over 1.5 years, with no identifiable cause found despite extensive work-up by specialists ranging from Rheumatologists to Oncologists. This case provides a learning opportunity on the approach to weight gain paired with persistent fevers in a paediatric population, one which is not commonly encountered and prompts further evaluation and consideration of less common diagnoses. In a span of 2 years, the girl’s weight had increased from 55 kg at 13 years old (75th centile) to 73.9 kg at 16 years old (>97th centile). About 1 year into her rapid weight gain, she started developing recurrent fevers of documented temperatures > 37.5 – 38.6 every 2-3 days, resulting in school absenteeism when she was sent home after temperature-taking in school found her to be febrile. The rapid onset of weight gain paired with unexplained fevers prompted the treating physician to consider the diagnosis of ROHHAD syndrome. Rapid onset obesity with hypoventilation, hypothalamic dysfunction and autonomic dysregulation (ROHHAD) syndrome is a rare disorder first described in 2007. It is characterized by dysfunction of the autonomic and endocrine system, characterized by hyperphagia and rapid-onset weight gain. This rapid weight gain is classically followed by hypothalamic manifestations with neuroendocrine deficiencies, hypo-ventilatory breathing abnormalities, and autonomic dysregulation. ROHHAD is challenging to diagnose with and diagnosis is made based mostly on clinical judgement. However if truly diagnosed, the condition is characterized by high morbidity and mortality rates. Early recognition of sleep disorders breathing and targeted therapeutic interventions helps limit morbidity and mortality associated with ROHHAD syndrome. This case poses an interesting diagnostic challenge and a diagnosis of ROHHAD has to be considered, given the serious complications that can come with disease progression while conditions such as Munchausen’s or drug fever remain as diagnoses of exclusion until we have exhausted all other possible conditions.

Keywords: pediatrics, endocrine, weight gain, recurrent fever, adolescent

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Authors: Dzul Fahmi Md. Nordin, Rosmini Omar

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This conceptual paper aims to explore the concept of National Talent Retention for a nation by extending the works on Talent Retention in organizations to the scope of nations. The objective of this paper is to explore the relationship of National Talent Retention as the dependent variable with the three explored value propositions namely Firm Value Proposition, Higher Education and Training Value Proposition and National Attractiveness Value Proposition as the independent variables. Life Satisfaction is introduced in this study as a moderating variable to explore possibilities of Life Satisfaction as a mediator for the relationship between National Value Proposition and National Talent Retention. Theories such as Migration, Value Propositions, Life Satisfaction, Human Resource Management and Resource Based View are referred to in order to understand and explore the concept of National Talent Retention. Malaysia is chosen as the background of this study since Malaysia represents a developing nation with progressive economic, education and national policy which presents an interesting background for this exploratory paper. Surprisingly, Malaysia is still facing the phenomenon of Brain Drain which if not handled properly will hinder its Vision 2020 to progress a fully developed nation by year 2020. Mixed methodology analysis is proposed in this paper to include both qualitative face-to-face interview as well as quantitative survey questionnaire to study on the value proposition factors explored. Target respondents are strictly confined to Malaysia’s local high skilled talents either residing in Malaysia or migrated abroad since this paper is mainly interested to study on the concept of National Talent Retention and how successful Malaysia is projecting its value propositions from the perception of high skilled talent Malaysians. It is hoped that this paper could contribute towards understanding National Talent Retention concept where, the model could be replicated to identify influential factors specific to other nations.

Keywords: national talent retention, national value proposition, life satisfaction, high skilled talents

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Authors: Ling-Lang Huang

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Background: The holistic health care should ideally cover physical, mental, spiritual, and social aspects of a patient. With very constrained time in current clinical practice system, medical decisions often tip the balance in favor of evidence-based medicine (EBM) in comparison to patient's personal values. Even in the era of competence-based medical education (CBME), when scrutinizing the items of entrustable professional activities (EPAs), we found that EPAs of establishing doctor-patient relationship remained incomplete or even missing. This phenomenon prompted us to raise this project aiming at advocating value-based medicine (VBM), which emphasizes the importance of patient’s values in medical decisions. A true and effective doctor-patient communication and relationship should be a well-balanced harmony of EBM and VBM. By constructing VBM into current EPAs, we can further promote genuine shared decision making (SDM) and fix the missing link in holistic health care. Methods: In this project, we are going to find out EPA elements crucial for establishing an ideal doctor-patient relationship through three distinct pairs of doctor-patient relationships: patients with pulmonary arterial hypertension (relatively young but with grave disease), patients undergoing surgery (facing critical medical decisions), and patients with terminal diseases (facing forthcoming death). We’ll search for important EPA elements through the following steps: 1. Narrative approach to delineate patients’ values among 2. distinct groups. 3.Hermeneutics-based interview: semi-structured interview will be conducted for both patients and physicians, followed by qualitative analysis of collected information by compiling, disassembling, reassembling, interpreting, and concluding. 4. Preliminarily construct those VBM elements into EPAs for doctor-patient relationships in 3 groups. Expected Outcomes: The results of this project are going to give us invaluable information regarding the impact of patients’ values, while facing different medical situations, on the final medical decision. The competence of well-blending and -balanced both values from patients and evidence from clinical sciences is the missing link in holistic health care and should be established in future EPAs to enhance an effective SDM.

Keywords: value-based medicine, shared decision making, entrustable professional activities, holistic health care

Procedia PDF Downloads 121