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Commenced in January 2007
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Paper Count: 8582

Search results for: term frequency-inverse document frequency

932 Multidisciplinary Approach to Mio-Plio-Quaternary Aquifer Study in the Zarzis Region (Southeastern Tunisia)

Authors: Ghada Ben Brahim, Aicha El Rabia, Mohamed Hedi Inoubli

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Climate change has exacerbated disparities in the distribution of water resources in Tunisia, resulting in significant degradation in quantity and quality over the past five decades. The Mio-Plio-Quaternary aquifer, the primary water source in the Zarzis region, is subject to climatic, geographical, and geological challenges, as well as human stress. The region is experiencing uneven distribution and growing threats from groundwater salinity and saltwater intrusion. Addressing this challenge is critical for the arid region’s socioeconomic development, and effective water resource management is required to combat climate change and reduce water deficits. This study uses a multidisciplinary approach to determine the groundwater potential of this aquifer, involving geophysics and hydrogeology data analysis. We used advanced techniques such as 3D Euler deconvolution and power spectrum analysis to generate detailed anomaly maps and estimate the depths of density sources, identifying significant Bouguer anomalies trending E-W, NW-SE, and NE-SW. Various techniques, such as wavelength filtering, upward continuation, and horizontal and vertical derivatives, were used to improve the gravity data, resulting in consistent results for anomaly shapes and amplitudes. The Euler deconvolution method revealed two prominent surface faults, trending NE-SW and NW-SE, that have a significant impact on the distribution of sedimentary facies and water quality within the Mio-Plio-Quaternary aquifer. Additionally, depth maxima greater than 1400 m to the North indicate the presence of a Cretaceous paleo-fault. Geoelectrical models and resistivity pseudo-sections were used to interpret the distribution of electrical facies in the Mio-Plio-Quaternary aquifer, highlighting lateral variation and depositional environment type. AI optimises the analysis and interpretation of exploration data, which is important to long-term management and water security. Machine learning algorithms and deep learning models analyse large datasets to provide precise interpretations of subsurface conditions, such as aquifer salinisation. However, AI has limitations, such as the requirement for large datasets, the risk of overfitting, and integration issues with traditional geological methods.

Keywords: mio-plio-quaternary aquifer, Southeastern Tunisia, geophysical methods, hydrogeological analysis, artificial intelligence

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931 The Role of Establishing Zakat-Based Finance in Alleviating Poverty in the Muslim World

Authors: Khan Md. Abdus Subhan, Rabeya Bushra

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The management of Intellectual Property (IP) in museums can be complex and challenging, as it requires balancing access and control. On the one hand, museums must ensure that they have balanced permissions to display works in their collections and make them accessible to the public. On the other hand, they must also protect the rights of creators and owners of works and ensure that they are not infringing on IP rights. Intellectual property has become an increasingly important aspect of museum operations in the digital age. Museums hold a vast array of cultural assets in their collections, many of which have significant value as IP assets. The balanced management of IP in museums can help generate additional revenue and promote cultural heritage while also protecting the rights of the museum and its collections. Digital technologies have greatly impacted the way museums manage IP, providing new opportunities for revenue generation through e-commerce and licensing while also presenting new challenges related to IP protection and management. Museums must take a comprehensive approach to IP management, leveraging digital technologies, protecting IP rights, and engaging in licensing and e-commerce activities to maximize income and the economy of countries through the strong management of cultural institutions. Overall, the balanced management of IP in museums is crucial for ensuring the sustainability of museum operations and for preserving cultural heritage for future generations. By taking a balanced approach to identifying museum IP assets, museums can generate revenues and secure their financial sustainability to ensure the long-term preservation of their cultural heritage. We can divide IP assets in museums into two kinds: collection IP and museum-generated IP. Certain museums become confused and lose sight of their mission when trying to leverage collections-based IP. This was the case at the German State Museum in Berlin when the museum made 100 replicas from the Nefertiti bust and wrote under the replicas all rights reserved to the Berlin Museum and issued a certificate to prevent any person or Institution from reproducing any replica from this bust. The implications of IP in museums are far-reaching and can have significant impacts on the preservation of cultural heritage, the dissemination of information, and the development of educational programs. As such, it is important for museums to have a comprehensive understanding of IP laws and regulations and to properly manage IP to avoid legal liability, damage to reputation, and loss of revenue. The research aims to highlight the importance and role of intellectual property in museums and provide some illustrative examples of this.

Keywords: zakat, economic development, Muslim world, poverty alleviation.

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930 Identification of Peroxisome Proliferator-Activated Receptors α/γ Dual Agonists for Treatment of Metabolic Disorders, Insilico Screening, and Molecular Dynamics Simulation

Authors: Virendra Nath, Vipin Kumar

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Background: TypeII Diabetes mellitus is a foremost health problem worldwide, predisposing to increased mortality and morbidity. Undesirable effects of the current medications have prompted the researcher to develop more potential drug(s) against the disease. The peroxisome proliferator-activated receptors (PPARs) are members of the nuclear receptors family and take part in a vital role in the regulation of metabolic equilibrium. They can induce or repress genes associated with adipogenesis, lipid, and glucose metabolism. Aims: Investigation of PPARα/γ agonistic hits were screened by hierarchical virtual screening followed by molecular dynamics simulation and knowledge-based structure-activity relation (SAR) analysis using approved PPAR α/γ dual agonist. Methods: The PPARα/γ agonistic activity of compounds was searched by using Maestro through structure-based virtual screening and molecular dynamics (MD) simulation application. Virtual screening of nuclear-receptor ligands was done, and the binding modes with protein-ligand interactions of newer entity(s) were investigated. Further, binding energy prediction, Stability studies using molecular dynamics (MD) simulation of PPARα and γ complex was performed with the most promising hit along with the structural comparative analysis of approved PPARα/γ agonists with screened hit was done for knowledge-based SAR. Results and Discussion: The silicone chip-based approach recognized the most capable nine hits and had better predictive binding energy as compared to the reference drug compound (Tesaglitazar). In this study, the key amino acid residues of binding pockets of both targets PPARα/γ were acknowledged as essential and were found to be associated in the key interactions with the most potential dual hit (ChemDiv-3269-0443). Stability studies using molecular dynamics (MD) simulation of PPARα and γ complex was performed with the most promising hit and found root mean square deviation (RMSD) stabile around 2Å and 2.1Å, respectively. Frequency distribution data also revealed that the key residues of both proteins showed maximum contacts with a potent hit during the MD simulation of 20 nanoseconds (ns). The knowledge-based SAR studies of PPARα/γ agonists were studied using 2D structures of approved drugs like aleglitazar, tesaglitazar, etc. for successful designing and synthesis of compounds PPARγ agonistic candidates with anti-hyperlipidimic potential.

Keywords: computational, diabetes, PPAR, simulation

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929 Strengthening Social and Psychological Resources - Project "Herausforderung" as a (Sports-) Pedagogical Concept in Adolescence

Authors: Kristof Grätz

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Background: Coping with crisis situations (e.g., the identity crisis in adolescence) is omnipresent in today's socialization and should be encouraged as a child. For this reason, students should be given the opportunity to create, endure and manage these crisis situations in a sporting context within the project “Herausforderung.” They should prove themselves by working on a self-assigned task, accompanied by ‚coaches’ in a place outside of their hometown. The aim of the project is to observe this process from a resource-oriented perspective. Health promotion, as called for by the WHO in the Ottawa Charter since 1986, includes strengthening psychosocial resources. These include cognitive, emotional, and social potentials that contribute to improving the quality of life, provide favourable conditions for coping with health burdens and enable people to influence their physical performance and well-being self-confidently and actively. A systematic strengthening of psychosocial resources leads to an improvement in mental health and contributes decisively to the regular implementation and long-term maintenance of this health behavior. Previous studies have already shown significant increases in self-concept following experiential educational measures [Fengler, 2007; Eberle & Fengler, 2018] and positive effects of experience-based school trips on the social competence of students [Reuker, 2009]. Method: The research project examines the influence of the project “Herausforderung” on psychosocial resources such as self-efficacy, self-concept, social support, and group cohesion. The students participating in the project will be tested in a pre-post design in the context of the challenge. This test includes specific questions to capture the different psychosocial resources. For the measurement, modifications of existing scales with good item selectivity and reliability are used to a large extent, so that acceptable item and scale values can be expected. If necessary, the scales were adapted or shortened to the specific context in order to ensure a balanced relationship between reliability and test economy. Specifically, these are already tested scales such as FRKJ 8-16, FSKN, GEQ, and F-SozU. The aim is to achieve a sample size of n ≥ 100. Conclusion: The project will be reviewed with regard to its effectiveness, and implications for a resource-enhancing application in sports settings will be given. Conclusions are drawn as to which extent to specific experiential educational content in physical education can have a health-promoting effect on the participants.

Keywords: children, education, health promotion, psychosocial resources

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928 A Left Testicular Cancer with Multiple Metastases Nursing Experience

Authors: Syue-Wen Lin

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Objective:This article reviews the care experience of a 40-year-old male patient who underwent a thoracoscopic right lower lobectomy following a COVID-19 infection. His complex medical history included multiple metastases (lungs, liver, spleen, and left kidney) and lung damage from COVID-19, which complicated the weaning process from mechanical ventilation. The care involved managing cancer treatment, postoperative pain, wound care, and palliative care. Methods:Nursing care was provided from August 16 to August 17, 2024. Challenges included difficulty with sputum clearance, which exacerbated the patient's anxiety and fear of reintubation. Pain management strategies combined analgesic drugs, non-drug methods, essential oil massages with family members, and playing the patient’s favorite music to reduce pain and anxiety. Progressive rehabilitation began with stabilizing vital signs, followed by assistance with sitting on the edge of the bed and walking within the ward. Strict sterile procedures and advanced wound care technology were used for daily dressing changes, with meticulous documentation of wound conditions and appropriate dressing selection. Holistic cancer care and palliative measures were integrated to address the patient’s physical and psychological needs. Results:The interdisciplinary care team developed a comprehensive plan addressing both physical and psychological aspects. Respiratory therapy, lung expansion exercises, and a high-frequency chest wall oscillation vest facilitated sputum expulsion and assisted in weaning from mechanical ventilation. The integration of cancer care, pain management, wound care, and palliative care led to improved quality of life and recovery. The collaborative approach between nursing staff and family ensured that the patient received compassionate and effective care. Conclusion: The complex interplay of emergency surgery, COVID-19, and advanced cancer required a multifaceted care strategy. The care team’s approach, combining critical care with tailored cancer and palliative care, effectively improved the patient’s quality of life and facilitated recovery. The comprehensive care plan, developed with family collaboration, provided both high-quality medical care and compassionate support for the terminally ill patient.

Keywords: multiple metastases, testicular cancer, palliative care, nursing experience

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927 Comparing the ‘Urgent Community Care Team’ Clinical Referrals in the Community with Suggestions from the Clinical Decision Support Software Dem DX

Authors: R. Tariq, R. Lee

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Background: Additional demands placed on senior clinical teams with ongoing COVID-19 management has accelerated the need to harness the wider healthcare professional resources and upskill them to take on greater clinical responsibility safely. The UK NHS Long Term Plan (2019)¹ emphasises the importance of expanding Advanced Practitioners’ (APs) roles to take on more clinical diagnostic responsibilities to cope with increased demand. In acute settings, APs are often the first point of care for patients and require training to take on initial triage responsibilities efficiently and safely. Critically, their roles include determining which onward services the patients may require, and assessing whether they can be treated at home, avoiding unnecessary admissions to the hospital. Dem Dx is a Clinical Reasoning Platform (CRP) that claims to help frontline healthcare professionals independently assess and triage patients. It guides the clinician from presenting complaints through associated symptoms to a running list of differential diagnoses, media, national and institutional guidelines. The objective of this study was to compare the clinical referral rates and guidelines adherence registered by the HMR Urgent Community Care Team (UCCT)² and Dem Dx recommendations using retrospective cases. Methodology: 192 cases seen by the UCCT were anonymised and reassessed using Dem Dx clinical pathways. We compared the UCCT’s performance with Dem Dx regarding the appropriateness of onward referrals. We also compared the clinical assessment regarding adherence to NICE guidelines recorded on the clinical notes and the presence of suitable guidance in each case. The cases were audited by two medical doctors. Results: Dem Dx demonstrated appropriate referrals in 85% of cases, compared to 47% in the UCCT team (p<0.001). Of particular note, Dem Dx demonstrated an almost 65% (p<0.001) improvement in the efficacy and appropriateness of referrals in a highly experienced clinical team. The effectiveness of Dem Dx is in part attributable to the relevant NICE and local guidelines found within the platform's pathways and was found to be suitable in 86% of cases. Conclusion: This study highlights the potential of clinical decision support, as Dem Dx, to improve the quality of onward clinical referrals delivered by a multidisciplinary team in primary care. It demonstrated that it could support healthcare professionals in making appropriate referrals, especially those that may be overlooked by providing suitable clinical guidelines directly embedded into cases and clear referral pathways. Further evaluation in the clinical setting has been planned to confirm those assumptions in a prospective study.

Keywords: advanced practitioner, clinical reasoning, clinical decision-making, management, multidisciplinary team, referrals, triage

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926 Association of Genetically Proxied Cholesterol-Lowering Drug Targets and Head and Neck Cancer Survival: A Mendelian Randomization Analysis

Authors: Danni Cheng

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Background: Preclinical and epidemiological studies have reported potential protective effects of low-density lipoprotein cholesterol (LDL-C) lowering drugs on head and neck squamous cell cancer (HNSCC) survival, but the causality was not consistent. Genetic variants associated with LDL-C lowering drug targets can predict the effects of their therapeutic inhibition on disease outcomes. Objective: We aimed to evaluate the causal association of genetically proxied cholesterol-lowering drug targets and circulating lipid traits with cancer survival in HNSCC patients stratified by human papillomavirus (HPV) status using two-sample Mendelian randomization (MR) analyses. Method: Single-nucleotide polymorphisms (SNPs) in gene region of LDL-C lowering drug targets (HMGCR, NPC1L1, CETP, PCSK9, and LDLR) associated with LDL-C levels in genome-wide association study (GWAS) from the Global Lipids Genetics Consortium (GLGC) were used to proxy LDL-C lowering drug action. SNPs proxy circulating lipids (LDL-C, HDL-C, total cholesterol, triglycerides, apoprotein A and apoprotein B) were also derived from the GLGC data. Genetic associations of these SNPs and cancer survivals were derived from 1,120 HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) and 2,570 non-HPV-driven HNSCC patients in VOYAGER program. We estimated the causal associations of LDL-C lowering drugs and circulating lipids with HNSCC survival using the inverse-variance weighted method. Results: Genetically proxied HMGCR inhibition was significantly associated with worse overall survival (OS) in non-HPV-drive HNSCC patients (inverse variance-weighted hazard ratio (HR IVW), 2.64[95%CI,1.28-5.43]; P = 0.01) but better OS in HPV-positive OPSCC patients (HR IVW,0.11[95%CI,0.02-0.56]; P = 0.01). Estimates for NPC1L1 were strongly associated with worse OS in both total HNSCC (HR IVW,4.17[95%CI,1.06-16.36]; P = 0.04) and non-HPV-driven HNSCC patients (HR IVW,7.33[95%CI,1.63-32.97]; P = 0.01). A similar result was found that genetically proxied PSCK9 inhibitors were significantly associated with poor OS in non-HPV-driven HNSCC (HR IVW,1.56[95%CI,1.02 to 2.39]). Conclusion: Genetically proxied long-term HMGCR inhibition was significantly associated with decreased OS in non-HPV-driven HNSCC and increased OS in HPV-positive OPSCC. While genetically proxied NPC1L1 and PCSK9 had associations with worse OS in total and non-HPV-driven HNSCC patients. Further research is needed to understand whether these drugs have consistent associations with head and neck tumor outcomes.

Keywords: Mendelian randomization analysis, head and neck cancer, cancer survival, cholesterol, statin

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925 Spatial Distribution and Cluster Analysis of Sexual Risk Behaviors and STIs Reported by Chinese Adults in Guangzhou, China: A Representative Population-Based Study

Authors: Fangjing Zhou, Wen Chen, Brian J. Hall, Yu Wang, Carl Latkin, Li Ling, Joseph D. Tucker

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Background: Economic and social reforms designed to open China to the world has been successful, but also appear to have rapidly laid the foundation for the reemergence of STIs since 1980s. Changes in sexual behaviors, relationships, and norms among Chinese contributed to the STIs epidemic. As the massive population moved during the last 30 years, early coital debut, multiple sexual partnerships, and unprotected sex have increased within the general population. Our objectives were to assess associations between residences location, sexual risk behaviors and sexually transmitted infections (STIs) among adults living in Guangzhou, China. Methods: Stratified cluster sampling followed a two-step process was used to select populations aged 18-59 years in Guangzhou, China. Spatial methods including Geographic Information Systems (GIS) were utilized to identify 1400 coordinates with latitude and longitude. Face-to-face household interviews were conducted to collect self-report data on sexual risk behaviors and diagnosed STIs. Kulldorff’s spatial scan statistic was implemented to identify and detect spatial distribution and clusters of sexual risk behaviors and STIs. The presence and location of statistically significant clusters were mapped in the study areas using ArcGIS software. Results: In this study, 1215 of 1400 households attempted surveys, with 368 refusals, resulting in a sample of 751 completed surveys. The prevalence of self-reported sexual risk behaviors was between 5.1% and 50.0%. The self-reported lifetime prevalence of diagnosed STIs was 7.06%. Anal intercourse clustered in an area located along the border within the rural-urban continuum (p=0.001). High rate clusters for alcohol or other drugs using before sex (p=0.008) and migrants who lived in Guangzhou less than one year (p=0.007) overlapped this cluster. Excess cases for sex without a condom (p=0.031) overlapped the cluster for college students (p<0.001). Conclusions: Short-term migrants and college students reported greater sexual risk behaviors. Programs to increase safer sex within these communities to reduce the risk of STIs are warranted in Guangzhou. Spatial analysis identified geographical clusters of sexual risk behaviors, which is critical for optimizing surveillance and targeting control measures for these locations in the future.

Keywords: cluster analysis, migrant, sexual risk behaviors, spatial distribution

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924 Modeling Standpipe Pressure Using Multivariable Regression Analysis by Combining Drilling Parameters and a Herschel-Bulkley Model

Authors: Seydou Sinde

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The aims of this paper are to formulate mathematical expressions that can be used to estimate the standpipe pressure (SPP). The developed formulas take into account the main factors that, directly or indirectly, affect the behavior of SPP values. Fluid rheology and well hydraulics are some of these essential factors. Mud Plastic viscosity, yield point, flow power, consistency index, flow rate, drillstring, and annular geometries are represented by the frictional pressure (Pf), which is one of the input independent parameters and is calculated, in this paper, using Herschel-Bulkley rheological model. Other input independent parameters include the rate of penetration (ROP), applied load or weight on the bit (WOB), bit revolutions per minute (RPM), bit torque (TRQ), and hole inclination and direction coupled in the hole curvature or dogleg (DL). The technique of repeating parameters and Buckingham PI theorem are used to reduce the number of the input independent parameters into the dimensionless revolutions per minute (RPMd), the dimensionless torque (TRQd), and the dogleg, which is already in the dimensionless form of radians. Multivariable linear and polynomial regression technique using PTC Mathcad Prime 4.0 is used to analyze and determine the exact relationships between the dependent parameter, which is SPP, and the remaining three dimensionless groups. Three models proved sufficiently satisfactory to estimate the standpipe pressure: multivariable linear regression model 1 containing three regression coefficients for vertical wells; multivariable linear regression model 2 containing four regression coefficients for deviated wells; and multivariable polynomial quadratic regression model containing six regression coefficients for both vertical and deviated wells. Although that the linear regression model 2 (with four coefficients) is relatively more complex and contains an additional term over the linear regression model 1 (with three coefficients), the former did not really add significant improvements to the later except for some minor values. Thus, the effect of the hole curvature or dogleg is insignificant and can be omitted from the input independent parameters without significant losses of accuracy. The polynomial quadratic regression model is considered the most accurate model due to its relatively higher accuracy for most of the cases. Data of nine wells from the Middle East were used to run the developed models with satisfactory results provided by all of them, even if the multivariable polynomial quadratic regression model gave the best and most accurate results. Development of these models is useful not only to monitor and predict, with accuracy, the values of SPP but also to early control and check for the integrity of the well hydraulics as well as to take the corrective actions should any unexpected problems appear, such as pipe washouts, jet plugging, excessive mud losses, fluid gains, kicks, etc.

Keywords: standpipe, pressure, hydraulics, nondimensionalization, parameters, regression

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923 Urinary Incontinence and Performance in Elite Athletes

Authors: María Barbaño Acevedo Gómez, Elena Sonsoles Rodríguez López, Sofía Olivia Calvo Moreno, Ángel Basas García, Christophe RamíRez Parenteau

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Introduction: Urinary incontinence (UI) is defined as the involuntary leakage of urine. In persons who practice sport, its prevalence is 36.1% (95% CI 26.5% –46.8%) and varies as it seems to depend on the intensity of exercise, movements and impact on the ground. Such high impact sports are likely to generate higher intra-abdominal pressures and leading to pelvic floor muscle weakness. Although physical exercise reduces the risk of suffering from many diseases the mentality of an elite athlete is not to optimize their health, achieving their goals can put their health at risk. Furthermore, feeling or suffering from any discomfort during training seems to be normal within the elite sport demands. Objective: The main objective of the present study was to know the effects of UI in sports performance in athletes. Methods: This was an observational study conducted in 754 elite athletes. After collecting questions about pelvic floor, UI and sport-related data, participants completed the questionnaire International Consultation on Incontinence Questionnaire-UI Short- Form (ICIQ-SF) and ISI (index of incontinence severity). Results: 48.8% of the athletes declare having losses also in rest, preseason and / or competition (χ2 [3] = 3.64; p = 0.302), being the competition period (29.1%) the most frequent where suffer from urine leakage. Of the elite athletes surveyed, 33% had UI according ICIQ-SF (mean age 23.75 ± 7.74 years). Elite athletes with UI (5.31 ± 1.07 days) dedicate significantly more days per week to training [M = 0.28; 95% CI = 0.08-0.48; t (752) = 2.78; p = 0.005] than those without UI. Regarding frequency, 59.7% lose urine once a week, 25.6% lose urine more than 3 times a week, and 14.7% daily. Based on the amount, approximately 15% claim to lose a moderate and abundant. Athletes with the highest number of urine leaks during their training, the UI affects them more in their daily life (r = 0.259; p = 0.001), they present a greater number of losses in their day to day (r = 0.341; p <0.001 ) and greater severity of UI (r = 0.341; p <0.001). Conclusions: Athletes consider that UI affects them negatively in their daily routine, 30.9% affirm having a severity between moderate and severe in their daily routine, and 29.1% loss urine in competition period. An interesting fact is that more than half of the samples collected were elite athletes who compete at the highest level (Olympic Games, World and European Championship), the dedication to sport occupies a big piece in their life. The most frequent period where athletes suffers urine leakage is in competition and there are many emotions that athletes manage to get their best performance, if we add urine losses in that moments it is possible that their performance could be affected.

Keywords: athletes, performance, prevalence, sport, training, urinary incontinence

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922 Retrospective Study on the Impacts of Age, Gender, Economic Status, Education Level and Drug Availability in Public Hospital on Seeking Care of Dermatological Condition in Rwanda

Authors: Uwizera Egide

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Introduction: Dermatological conditions are one of the most burdensome diseases in our health system. Global studies suggest that around 1 in 3 people gets a skin disease at a certain point in their life, though this does not necessarily guarantee the urge to consult. For a high-ranking disease, it is surprising how there is not enough data to support its effect on the economy and the general health system impact. It is for that reason that this study’s aim is to identify the burden of dermatological conditions in Rwanda so as to have a general picture of what our population is going through in regards to dermatological conditions. Methods: We used a cross sectional retrospective study. Data were obtained from patient’s information recorded in an open clinic at CHUB in a period of six months from July to December of the year 2021. Results: The study had a total of 4600 patients who attended dermatology service in a period of six months from July to December of the year 2021. We found a list of 102 dermatological diseases that presented at variable rates. The most prevalent disease was atopic dermatitis, at a rate of 23%. About 90% of presented conditions had only one choice of treatment from the hospital pharmacy. Most patients who presented were between 18-35 years old and with a predominance of the female gender; the level of education was either secondary or University Degree in our study, 65.4% of patients who presented were female; the majority, around 45% were between 18-35 years old, mostly being single 56%. The majority came from Southern province as it is the location of the hospital. The insurance mostly used was community-based health insurance with 63.8%, followed by RSSB with 18.5%, MS/UR, and other private insurances. The frequency of group drugs prescribed among all dermatological medications, steroids were the most commonly given medications at a rate of 39%, followed by emollients, antibiotics, and antifungal. The drugs prescribed were mostly available in the pharmacy of CHUB, with 60% and 40% being found in pharmacies outside the hospital. Conclusion: Dermatological conditions are prevalent in all age groups and distributed through all socioeconomic classes. About 9.2% of patient who consulted CHUB in 2021 presented one Dermatological condition of which 40 % of prescribed medications is never found in Hospital urging a need to buy medication in private pharmacies with more expenses and a risk of not complying on prescribed medication if in case they can’t afford paying them outside the CHUB. This finding urges a need to avail all essential dermatological drugs in hospital pharmacies to allow our patients to get them for the proper compliance of prescribed drugs in the management of skin diseases.

Keywords: atopic dermatitis, CHUB (centre hopitalier univerisitaire de butare), dermatological condition, fungal infections

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921 Autonomy in Pregnancy and Childbirth: The Next Frontier of Maternal Health Rights Advocacy

Authors: Alejandra Cardenas, Ona Flores, Fabiola Gretzinger

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Since the 1990s, legal strategies for the promotion and protection of maternal health rights have achieved significant gains. Successful litigation in courts around the world have shown that these rights can be judicially enforceable. Governments and international organizations have acknowledged the importance of a human rights-based approach to maternal mortality and morbidity, and obstetric violence has been recognized as a human rights issue. Despite the progress made, maternal mortality has worsened in some regions of the world, while progress has stagnated elsewhere, and mistreatment in maternal care is reported almost universally. In this context, issues of maternal autonomy and decision-making during pregnancy, labor, and delivery as a critical barrier to access quality maternal health have been largely overlooked. Indeed, despite the principles of autonomy and informed consent in medical interventions being well-established in international and regional norms, how they are applied particularly during childbirth and pregnancy remains underdeveloped. National and global legal standards and decisions related to maternal health were reviewed and analyzed to determine how maternal autonomy and decision-making during pregnancy, labor, and delivery have been protected (or not) by international and national courts. The results of this legal research and analysis lead to the conclusion that a few standards have been set by courts regarding pregnant people’s rights to make choices during pregnancy and birth; however, most undermine the agency of pregnant people. These decisions recognize obstetric violence and gender-based discrimination, but fail to protect pregnant people’s autonomy, privacy, and their right to informed consent. As current human rights standards stand today, maternal health is the only field in medicine and law in which informed consent can be overridden, and patients can be forced to submit to treatments against their will. Unconsented treatment and loss of agency during pregnancy and childbirth can have long-term physical and mental impacts, reduce satisfaction and trust in health systems, and may deter future health-seeking behaviors. This research proposes a path forward that focuses on the pregnant person as an independent agent, relying on the doctrine of self-determination during pregnancy and childbirth, which includes access to the necessary conditions to enable autonomy and choice throughout pregnancy and childbirth as a critical step towards our approaches to reduce maternal mortality, morbidity, and mistreatment, and realize the promise of access to quality maternal health as a human right.

Keywords: autonomy in childbirth and pregnancy, choice, informed consent, jurisprudential analysis

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920 Astronomy in the Education Area: A Narrative Review

Authors: Isabella Lima Leite de Freitas

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The importance of astronomy for humanity is unquestionable. Despite being a robust science, capable of bringing new discoveries every day and quickly increasing the ability of researchers to understand the universe more deeply, scientific research in this area can also help in various applications outside the domain of astronomy. The objective of this study was to review and conduct a descriptive analysis of published studies that presented the importance of astronomy in the area of education. A narrative review of the literature has been performed, considering the articles published in the last five years. As astronomy involves the study of physics, chemistry, biology, mathematics and technology, one of the studies evaluated presented astronomy as the gateway to science, demonstrating the presence of astronomy in 52 school curricula in 37 countries, with celestial movement the dominant content area. Another intervention study, evaluating individuals aged 4-5 years, demonstrated that the attribution of personal characteristics to cosmic bodies, in addition to the use of comprehensive astronomy concepts, favored the learning of science in preschool-age children, considering the use of practical activities of accompaniment and free drawing. Aiming to measure scientific literacy, another study developed in Turkey, motivated the authorities of this country to change the teaching materials and curriculum of secondary schools after the term “astronomy” appeared as one of the most attractive subjects for young people aged 15 to 24. There are also reports in the literature of the use of pedagogical tools, such as the representation of the Solar System on a human scale, where students can walk along the orbits of the planets while studying the laws of dynamics. The use of this tool favored the teaching of the relationship between distance, duration and speed over the period of the planets, in addition to improving the motivation and well-being of students aged 14-16. An important impact of astronomy on education was demonstrated in the study that evaluated the participation of high school students in the Astronomical Olympiads and the International Astronomy Olympiad. The study concluded that these Olympics have considerable influence on students who pursue a career in teaching or research later on, many of whom are in the area of astronomy itself. In addition, the literature indicates that the teaching of astronomy in the digital age has facilitated the availability of data for researchers, but also for the general population. This fact can increase even more the curiosity that the astronomy area has always instilled in people and promote the dissemination of knowledge on an expanded scale. Currently, astronomy has been considered an important ally in strengthening the school curricula of children, adolescents and young adults. This has been used as teaching tools, in addition to being extremely useful for scientific literacy, being increasingly used in the area of education.

Keywords: astronomy, education area, teaching, review

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919 Evaluation of Soil Erosion Risk and Prioritization for Implementation of Management Strategies in Morocco

Authors: Lahcen Daoudi, Fatima Zahra Omdi, Abldelali Gourfi

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In Morocco, as in most Mediterranean countries, water scarcity is a common situation because of low and unevenly distributed rainfall. The expansions of irrigated lands, as well as the growth of urban and industrial areas and tourist resorts, contribute to an increase of water demand. Therefore in the 1960s Morocco embarked on an ambitious program to increase the number of dams to boost water retention capacity. However, the decrease in the capacity of these reservoirs caused by sedimentation is a major problem; it is estimated at 75 million m3/year. Dams and reservoirs became unusable for their intended purposes due to sedimentation in large rivers that result from soil erosion. Soil erosion presents an important driving force in the process affecting the landscape. It has become one of the most serious environmental problems that raised much interest throughout the world. Monitoring soil erosion risk is an important part of soil conservation practices. The estimation of soil loss risk is the first step for a successful control of water erosion. The aim of this study is to estimate the soil loss risk and its spatial distribution in the different fields of Morocco and to prioritize areas for soil conservation interventions. The approach followed is the Revised Universal Soil Loss Equation (RUSLE) using remote sensing and GIS, which is the most popular empirically based model used globally for erosion prediction and control. This model has been tested in many agricultural watersheds in the world, particularly for large-scale basins due to the simplicity of the model formulation and easy availability of the dataset. The spatial distribution of the annual soil loss was elaborated by the combination of several factors: rainfall erosivity, soil erodability, topography, and land cover. The average annual soil loss estimated in several basins watershed of Morocco varies from 0 to 50t/ha/year. Watersheds characterized by high-erosion-vulnerability are located in the North (Rif Mountains) and more particularly in the Central part of Morocco (High Atlas Mountains). This variation of vulnerability is highly correlated to slope variation which indicates that the topography factor is the main agent of soil erosion within these basin catchments. These results could be helpful for the planning of natural resources management and for implementing sustainable long-term management strategies which are necessary for soil conservation and for increasing over the projected economic life of the dam implemented.

Keywords: soil loss, RUSLE, GIS-remote sensing, watershed, Morocco

Procedia PDF Downloads 462
918 Learning Instructional Managements between the Problem-Based Learning and Stem Education Methods for Enhancing Students Learning Achievements and their Science Attitudes toward Physics the 12th Grade Level

Authors: Achirawatt Tungsombatsanti, Toansakul Santiboon, Kamon Ponkham

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Strategies of the STEM education was aimed to prepare of an interdisciplinary and applied approach for the instructional of science, technology, engineering, and mathematics in an integrated students for enhancing engagement of their science skills to the Problem-Based Learning (PBL) method in Borabu School with a sample consists of 80 students in 2 classes at the 12th grade level of their learning achievements on electromagnetic issue. Research administrations were to separate on two different instructional model groups, the 40-experimental group was designed with the STEM instructional experimenting preparation and induction in a 40-student class and the controlling group using the PBL was designed to students identify what they already know, what they need to know, and how and where to access new information that may lead to the resolution of the problem in other class. The learning environment perceptions were obtained using the 35-item Physics Laboratory Environment Inventory (PLEI). Students’ creating attitude skills’ sustainable development toward physics were assessed with the Test Of Physics-Related Attitude (TOPRA) The term scaling was applied to the attempts to measure the attitude objectively with the TOPRA was used to assess students’ perceptions of their science attitude toward physics. Comparisons between pretest and posttest techniques were assessed students’ learning achievements on each their outcomes from each instructional model, differently. The results of these findings revealed that the efficiency of the PLB and the STEM based on criteria indicate that are higher than the standard level of the 80/80. Statistically, significant of students’ learning achievements to their later outcomes on the controlling and experimental physics class groups with the PLB and the STEM instructional designs were differentiated between groups at the .05 level, evidently. Comparisons between the averages mean scores of students’ responses to their instructional activities in the STEM education method are higher than the average mean scores of the PLB model. Associations between students’ perceptions of their physics classes to their attitudes toward physics, the predictive efficiency R2 values indicate that 77%, and 83% of the variances in students’ attitudes for the PLEI and the TOPRA in physics environment classes were attributable to their perceptions of their physics PLB and the STEM instructional design classes, consequently. An important of these findings was contributed to student understanding of scientific concepts, attitudes, and skills as evidence with STEM instructional ought to higher responding than PBL educational teaching. Statistically significant between students’ learning achievements were differentiated of pre and post assessments which overall on two instructional models.

Keywords: learning instructional managements, problem-based learning, STEM education, method, enhancement, students learning achievements, science attitude, physics classes

Procedia PDF Downloads 228
917 Examining Attrition in English Education: A Qualitative Study of the Impact of Preparation, Persistence, and Dispositions in Teacher Education

Authors: Pamela K. Coke, Heidi Frederiksen, Ann Sebald

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Over the past three years, the researchers have been tracking a rise in the number of teacher education candidates leaving the field before completing their university’s educator preparation program. At their institution, this rise is most pronounced in English Education. The purpose of this qualitative research study is to understand English Education teacher candidates' expectations in becoming prepared educators at each phase of their four phase teacher education program at one institution of higher education in the United States. Research questions include: To what extent do we find differences in teacher candidates' expectations of their teacher training program and student teaching experiences based upon undergraduate and graduate programs? Why do (or do not) teacher candidates persist in their teacher training program and student teaching experiences? How do dispositions develop through the course of the teacher training program? What supports do teacher candidates self-identify as needing at each phase of the teacher training program? Based upon participant interviews at each phase of the teacher education program, the researchers, all teacher educators, examine the extent to which English Education students feel prepared to student teach, focusing on preparation, persistence, and dispositions. The Colorado State University Center for Educator Preparation (CEP) provides students with information about teaching dispositions, or desired professional behaviors, throughout their education program. CEP focuses these dispositions around nine categories: Professional Behaviors, Initiative and Dependability, Tact and Judgment, Ethical Behavior and Integrity, Collegiality and Responsiveness, Effective Communicator, Desire to Improve Own Performance, Culturally Responsive, and Commitment to the Profession. Currently, in the first phase of a four phase study, initial results indicate participants expect their greatest joys will be working with and learning from students. They anticipate their greatest challenges will involve discipline and confidence. They predict they will persist in their program because they believe the country needs well-prepared teachers and they have a commitment to their professional growth. None of the participants thus far could imagine why they would leave the program. With regard to strongest and weakest dispositions, results are mixed. Some participants see Tact and Judgment as their strongest disposition; others see it as their weakest. All participants stated mentoring is a necessary support at every phase of the teacher preparation process. This study informs the way teacher educators train and evaluate teacher candidates, and has implications for the frequency and types of feedback students receive from mentors and supervisors. This research contributes to existing work on teacher retention, candidate persistence, and dispositional development.

Keywords: English education, dispositions, persistence, teacher preparation

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916 Monitoring Potential Temblor Localities as a Supplemental Risk Control System

Authors: Mikhail Zimin, Svetlana Zimina, Maxim Zimin

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Without question, the basic method of prevention of human and material losses is the provision for adequate strength of constructions. At the same time, seismic load has a stochastic character. So, at all times, there is little danger of earthquake forces exceeding the selected design load. This risk is very low, but the consequences of such events may be extremely serious. Very dangerous are also occasional mistakes in seismic zoning, soil conditions changing before temblors, and failure to take into account hazardous natural phenomena caused by earthquakes. Besides, it is known that temblors detrimentally affect the environmental situation in regions where they occur, resulting in panic and worsening various disease courses. It may lead to mistakes of personnel of hazardous production facilities like the production and distribution of gas and oil, which may provoke severe accidents. In addition, gas and oil pipelines often have long mileage and cross many perilous zones by contrast with buildings. This situation increases the risk of heavy accidents. In such cases, complex monitoring of potential earthquake localities would be relevant. Even though the number of successful real-time forecasts of earthquakes is not great, it is well in excess, such as may be under random guessing. Experimental performed time-lapse study and analysis consist of searching seismic, biological, meteorological, and light earthquake precursors, processing such data with the help of fuzzy sets, collecting weather information, utilizing a database of terrain, and computing risk of slope processes under the temblor in a given setting. Works were done in a real-time environment and broadly acceptable results took place. Observations from already in-place seismic recording systems are used. Furthermore, a look back study of precursors of known earthquakes is done. Situations before Ashkhabad, Tashkent, and Haicheng seismic events are analyzed. Fairish findings are obtained. Results of earthquake forecasts can be used for predicting dangerous natural phenomena caused by temblors such as avalanches and mudslides. They may also be utilized for prophylaxis of some diseases and their complications. Relevant software is worked out too. It should be emphasized that such control does not require serious financial expenses and can be performed by a small group of professionals. Thus, complex monitoring of potential earthquake localities, including short-term earthquake forecasts and analysis of possible hazardous consequences of temblors, may further the safety of pipeline facilities.

Keywords: risk, earthquake, monitoring, forecast, precursor

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915 Ultra-Tightly Coupled GNSS/INS Based on High Degree Cubature Kalman Filtering

Authors: Hamza Benzerrouk, Alexander Nebylov

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In classical GNSS/INS integration designs, the loosely coupled approach uses the GNSS derived position and the velocity as the measurements vector. This design is suboptimal from the standpoint of preventing GNSSoutliers/outages. The tightly coupled GPS/INS navigation filter mixes the GNSS pseudo range and inertial measurements and obtains the vehicle navigation state as the final navigation solution. The ultra‐tightly coupled GNSS/INS design combines the I (inphase) and Q(quadrature) accumulator outputs in the GNSS receiver signal tracking loops and the INS navigation filter function intoa single Kalman filter variant (EKF, UKF, SPKF, CKF and HCKF). As mentioned, EKF and UKF are the most used nonlinear filters in the literature and are well adapted to inertial navigation state estimation when integrated with GNSS signal outputs. In this paper, it is proposed to move a step forward with more accurate filters and modern approaches called Cubature and High Degree cubature Kalman Filtering methods, on the basis of previous results solving the state estimation based on INS/GNSS integration, Cubature Kalman Filter (CKF) and High Degree Cubature Kalman Filter with (HCKF) are the references for the recent developed generalized Cubature rule based Kalman Filter (GCKF). High degree cubature rules are the kernel of the new solution for more accurate estimation with less computational complexity compared with the Gauss-Hermite Quadrature (GHQKF). Gauss-Hermite Kalman Filter GHKF which is not selected in this work because of its limited real-time implementation in high-dimensional state-spaces. In ultra tightly or a deeply coupled GNSS/INS system is dynamics EKF is used with transition matrix factorization together with GNSS block processing which is well described in the paper and assumes available the intermediary frequency IF by using a correlator samples with a rate of 500 Hz in the presented approach. GNSS (GPS+GLONASS) measurements are assumed available and modern SPKF with Cubature Kalman Filter (CKF) are compared with new versions of CKF called high order CKF based on Spherical-radial cubature rules developed at the fifth order in this work. Estimation accuracy of the high degree CKF is supposed to be comparative to GHKF, results of state estimation are then observed and discussed for different initialization parameters. Results show more accurate navigation state estimation and more robust GNSS receiver when Ultra Tightly Coupled approach applied based on High Degree Cubature Kalman Filter.

Keywords: GNSS, INS, Kalman filtering, ultra tight integration

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914 Bauhaus Exhibition 1922: New Weapon of Anti-Colonial Resistance in India

Authors: Suneet Jagdev

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The development of the original Bauhaus occurred at a time in the beginning of the 20th century when the industrialization of Germany had reached a climax. The cities were a reflection of the new living conditions of an industrialized society. The Bauhaus can be interpreted as an ambitious attempt to find appropriate answers to the challenges by using architecture-urban development and design. The core elements of the conviction of the day were the belief in the necessary crossing of boundaries between the various disciplines and courage to experiment for a better solution. Even after 100 years, the situation in our cities is shaped by similar complexity. The urban consequences of developments are difficult to estimate and to predict. The paper critically reflected on the central aspects of the history of the Bauhaus and its role in bringing the modernism in India by comparative studies of the methodology adopted by the artists and designer in both the countries. The paper talked in detail about how the Bauhaus Exhibition in 1922 offered Indian artists a new weapon of anti-colonial resistance. The original Bauhaus fought its aesthetic and political battles in the context of economic instability and the rise of German fascism. The Indians had access to dominant global languages and in a particular English. The availability of print media and a vibrant indigenous intellectual culture provided Indian people a tool to accept technology while denying both its dominant role in culture and the inevitability of only one form of modernism. The indigenous was thus less an engagement with their culture as in the West than a tool of anti-colonial struggle. We have shown how the Indian people used Bauhaus as a critique of colonialism itself through an undermining of its typical modes of representation and as a means of incorporating the Indian desire for spirituality into art and as providing the cultural basis for a non-materialistic and anti-industrial form of what we might now term development. The paper reflected how through painting the Bauhaus entered the artistic consciousness of the sub-continent not only for its stylistic and technical innovations but as a tool for a critical and even utopian modernism that could challenge both the hegemony of academic and orientalist art and as the bearer of a transnational avant-garde as much political as it was artistic, and as such the basis of a non-Eurocentric but genuinely cosmopolitan alternative to the hierarchies of oppression and domination that had long bound India and were at that moment rising once again to a tragic crescendo in Europe. We have talked about how the Bauhaus of today can offer an innovative orientation towards discourse around architecture and design.

Keywords: anti-colonial struggle, art over architecture, Bauhaus exhibition of 1922, industrialization

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913 The Effectiveness of a Six-Week Yoga Intervention on Body Awareness, Warnings of Relapse, and Emotion Regulation among Incarcerated Females

Authors: James Beauchemin

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Introduction: The incarceration of people with mental illness and substance use disorders is a major public health issue, with social, clinical, and economic implications. Yoga participation has been associated with numerous psychological benefits; however, there is a paucity of research examining impacts of yoga with incarcerated populations. The purpose of this study was to evaluate effectiveness of a six-week yoga intervention on several mental health-related variables, including emotion regulation, body awareness, and warnings of substance relapse among incarcerated females. Methods: This study utilized a pre-post, three-arm design, with participants assigned to intervention, therapeutic community, or general population groups. A between-groups analysis of covariance (ANCOVA) was conducted across groups to assess intervention effectiveness using the Difficulties in Emotion Regulation Scale (DERS), Scale of Body Connection (SBC), and Warnings of Relapse (AWARE) Questionnaire. Results: ANCOVA results for warnings of relapse (AWARE) revealed significant between-group differences F(2, 80) = 7.15, p = .001; np2 = .152), with significant pairwise comparisons between the intervention group and both the therapeutic community (p = .001) and the general population (p = .005) groups. Similarly, significant differences were found for emotional regulation (DERS) F(2, 83) = 10.521, p = .000; np2 = .278). Pairwise comparisons indicated a significant difference between the intervention and general population (p = .01). Finally, significant differences between the intervention and control groups were found for body awareness (SBC) F(2, 84) = 3.69, p = .029; np2 = .081). Between-group differences were clarified via pairwise comparisons, indicating significant differences between the intervention group and both the therapeutic community (p = .028) and general population groups (p = .020). Implications: Study results suggest that yoga may be an effective addition to integrative mental health and substance use treatment for incarcerated women, and contributes to increasing evidence that holistic interventions may be an important component for treatment with this population. Specifically, given the prevalence of mental health and substance use disorders, findings revealed that changes in body awareness and emotion regulation may be particularly beneficial for incarcerated populations with substance use challenges as a result of yoga participation. From a systemic perspective, this proactive approach may have long-term implications for both physical and psychological well-being for the incarcerated population as a whole, thereby decreasing the need for traditional treatment. By integrating a more holistic, salutogenic model that emphasizes prevention, interventions like yoga may work to improve the wellness of this population, while providing an alternative or complementary treatment option for those with current symptoms.

Keywords: yoga, mental health, incarceration, wellness

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912 An Audit on the Role of Sentinel Node Biopsy in High-Risk Ductal Carcinoma in Situ and Intracystic Papillary Carcinoma

Authors: M. Sulieman, H. Arabiyat, H. Ali, K. Potiszil, I. Abbas, R. English, P. King, I. Brown, P. Drew

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Introduction: The incidence of breast ductal Carcinoma in Situ (DCIS) has been increasing; it currently represents up 20-25% of all breast carcinomas. Some aspects of DCIS management are still controversial, mainly due to the heterogeneity of its clinical presentation and of its biological and pathological characteristics. In DCIS, histological diagnosis obtained preoperatively, carries the risk of sampling error if the presence of invasive cancer is subsequently diagnosed. The mammographic extent over than 4–5 cm and the presence of architectural distortion, focal asymmetric density or mass on mammography are proven important risk factors of preoperative histological under staging. Intracystic papillary cancer (IPC) is a rare form of breast carcinoma. Despite being previously compared to DCIS it has been shown to present histologically with invasion of the basement membrane and even metastasis. SLNB – Carries the risk of associated comorbidity that should be considered when planning surgery for DCIS and IPC. Objectives: The aim of this Audit was to better define a ‘high risk’ group of patients with pre-op diagnosis of non-invasive cancer undergoing breast conserving surgery, who would benefit from sentinel node biopsy. Method: Retrospective data collection of all patients with ductal carcinoma in situ over 5 years. 636 patients identified, and after exclusion criteria applied: 394 patients were included. High risk defined as: Extensive micro-calcification >40mm OR any mass forming DCIS. IPC: Winpath search from for the term ‘papillary carcinoma’ in any breast specimen for 5 years duration;.29 patients were included in this group. Results: DCIS: 188 deemed high risk due to >40mm calcification or a mass forming (radiological or palpable) 61% of those had a mastectomy and 32% BCS. Overall, in that high-risk group - the number with invasive disease was 38%. Of those high-risk DCIS pts 85% had a SLN - 80% at the time of surgery and 5% at a second operation. For the BCS patients - 42% had SLN at time of surgery and 13% (8 patients) at a second operation. 15 (7.9%) pts in the high-risk group had a positive SLNB, 11 having a mastectomy and 4 having BCS. IPC: The provisional diagnosis of encysted papillary carcinoma is upgraded to an invasive carcinoma on final histology in around a third of cases. This has may have implications when deciding whether to offer sentinel node removal at the time of therapeutic surgery. Conclusions: We have defined a ‘high risk’ group of pts with pre-op diagnosis of non-invasive cancer undergoing BCS, who would benefit from SLNB at the time of the surgery. In patients with high-risk features; the risk of invasive disease is up to 40% but the risk of nodal involvement is approximately 8%. The risk of morbidity from SLN is up to about 5% especially the risk of lymphedema.

Keywords: breast ductal carcinoma in Situ (DCIS), intracystic papillary carcinoma (IPC), sentinel node biopsy (SLNB), high-risk, non-invasive, cancer disease

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911 A Collaborative Approach to Improving Mental and Physical Health-Related Outcomes for a Heart Transplant Patient Through Music and Art Therapy Treatment

Authors: Elizabeth Laguaite, Alexandria Purdy

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Heart transplant recipients face psycho-physiological stressors, including pain, lengthy hospitalizations, delirium, and existential crises. They pose an increased risk for Post Traumatic Stress Disorder (PTSD) and can be a predictor of poorer mental and physical Health-Related Quality of Life (HRQOL) outcomes and increased mortality. There is limited research on the prevention of Post Traumatic Stress Symptoms (PTSS) in transplant patients. This case report focuses on a collaborative Music and Art Therapy intervention used to improve outcomes for HMH transplant recipient John (Alias). John, a 58-year-old man with congestive heart failure, was admitted to HMH in February of 2021 with cardiogenic shock, cannulated with an Intra-aortic Balloon Pump, Impella 5.5, and Venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO) as a bridge to heart and kidney transplant. He was listed as status 1 for transplant. Music Therapy and Art Therapy (MT and AT) were ordered by the physician for mood regulation, trauma processing and anxiety management. During MT/AT sessions, John reported a history of anxiety and depression exacerbated by medical acuity, shortness of breath, and lengthy hospitalizations. He expressed difficulty sleeping, pain, and existential questions. Initially seen individually by MT/AT, it was determined he could benefit from a collaborative approach due to similar thematic content within sessions. A Life Review intervention was developed by MT/AT. The purpose was for him to creatively express, reflect and process his medical narrative, including the identification of positive and negative events leading up to admission at HMH, the journey to transplant, and his hope for the future. Through this intervention, he created artworks that symbolized each event and paired them with songs, two of which were composed with the MT during treatment. As of September 2023, John has not been readmitted to the hospital and expressed that this treatment is what “got him through transplant”. MT and AT can provide opportunities for a patient to reminisce through creative expression, leading to a shift in the personal meaning of these experiences, promoting resolution, and ameliorating associated trauma. The closer to trauma it is processed, the less likely to develop PTSD. This collaborative MT/AT approach could improve long-term outcomes by reducing mortality and readmission rates for transplant patients.

Keywords: art therapy, music therapy, critical care, PTSD, trauma, transplant

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910 Rural Farmers-Herdsmen Conflicts, State Mediation Failure and Prospects of Traditional Institutions’ Intervention in Southwest Nigeria

Authors: Grace Adebo

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Rural Farmers-herdsmen conflicts have resulted in a large number of causalities in many parts of Nigeria. Herds of cattle have died, while farmers recorded inestimable losses of their crops and harvests. The overall consequences have impacted negatively on food security across the country. There are divided opinions by scholars, agricultural experts and conflict analysts on the root causes of the conflicts and why traditional institutional interventions are ineffective in resolving the crisis. The study, therefore, aims to investigate the fundamentality of the conflicts’ causes in Southwest Nigeria and the correlates between traditional institutional authorities’ intervention and farmers-herdsmen conflicts in Southwest Nigeria. A structured interview schedule and focus group discussion were employed to elicit information from 180 farmers and 48 herdsmen selected through a multistage sampling procedure from the conflict zones in Southwest Nigeria. Collected data were analyzed using frequency counts, percentages, means and the Relative Importance Index (RII). The study found that climate change effects, farmland encroachment, crop damage, theft, and competition for land and water resources and pollution were the root causes of the violent herders-rural farmer’s clashes. The quest for wealth acquisition by some traditional rulers and some notable individuals in the conflict neighborhoods, occasioned tribal-mix herds possession and, thus undermining local institutional interventions and perverting justice through weak conflict resolution strategies, therefore, fueling further conflicts. Most farmers in the conflict zones have abandoned their farms for fear of death. This coupled with physical, social, economic and psychological consequences have deepened food insecurity and impaired the economic conditions of the herdsmen and the farmers. Currently, there are no mutually established mediation mechanisms as most states are opposed to the enactment of grazing laws to protect territorial encroachments of lands and subsequent multiplication of the herdsmen. It is suggested that government and Non-Governmental Organisation (NGOs) should encourage a functional stakeholder's forum for sustainable conflict resolution and establish a compensation scheme for losses incurred while extension agents are equipped with knowledge on conflict management strategies for peace attainment with the envisioned goal of achieving sustainable livelihoods and food security in Southwest Nigeria.

Keywords: conflict resolution, food security, herdsmen-farmers conflict, sustainable livelihoods, traditional institutions

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909 User Expectations and Opinions Related to Campus Wayfinding and Signage Design: A Case Study of Kastamonu University

Authors: Güllü Yakar, Adnan Tepecik

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A university campus resembles an independent city that is spread over a wide area. Campuses that incorporate thousands of new domestic and international users at the beginning of every academic period also host scientific, cultural and sportive events, in addition to embodying regular users such as students and staff. Wayfinding and signage systems are necessary for the regulation of vehicular traffic, and they enable users’ to navigate without losing time or feeling anxiety. While designing the system or testing the functionality of it, opinions of existing users or likely behaviors of typical user profiles (personas) provide designers with insight. The purpose of this study is to identify the wayfinding attitudes and expectations of Kastamonu University Kuzeykent Campus users. This study applies a mixed method in which a questionnaire, developed by the researcher, constitute the quantitative phase of the study. The survey was carried out with 850 participants who filled a questionnaire form which was tested in terms of construct validity by using Exploratory Factor Analysis. While interpreting the data obtained, Chi-Square, T- Test and ANOVA analyses were applied as well as descriptive analyses such as frequency (f) and percentage (%) values. The results of this survey, which was conducted during the absence of systematic wayfinding signs in the campus, reveals the participants expectations for insertion of floor plans and wayfinding signs to indoors, maps to outdoors, symbols and color codes to the existing signs and for the adequate arrangement of those for the use of visually impaired people. The fact that there is a direct proportional relation between the length of institution membership and wayfinding competency within campus, leads to the conclusion that especially the new comers are in need of wayfinding signs. In order to determine the effectiveness of campus-wide wayfinding system implemented after the survey and in order to identify the further expectations of users in this respect, a semi-structured interview form developed by the researcher and assessments of 20 participants are compiled. Subjected to content analysis, this data constitute the qualitative dimension of the study. Research results indicate that despite the presence of the signs, the participants experienced either inability or stress while finding their way, showed tendency to receive help from others and needed outdoor maps and signs, in addition to bigger-sized texts.

Keywords: environmental graphic design, environmental perception, wayfinding and signage design, wayfinding system

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908 Aesthetics and Semiotics in Theatre Performance

Authors: Păcurar Diana Istina

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Structured in three chapters, the article attempts an X-ray of the theatrical aesthetics, correctly understood through the emotions generated in the intimate structure of the spectator that precedes the triggering of the viewer’s perception and not through the superposition, unfortunately common, of the notion of aesthetics with the style in which a theater show is built. The first chapter contains a brief history of the appearance of the word aesthetic, the formulation of definitions for this new term, as well as its connections with the notions of semiotics, in particular with the perception of the message transmitted. Starting with Aristotle and Plato, and reaching Magritte, their interventions should not be interpreted in the sense that the two scientific concepts can merge into one discipline. The perception that is the object of everyone’s analysis, the understanding of meaning, the decoding of the messages sent, and the triggering of feelings that culminate in pleasure, shaping the aesthetic vision, are some elements that keep semiotics and aesthetics distinct, even though they share many methods of analysis. The compositional processes of aesthetic representation and symbolic formation are analyzed in the second part of the paper from perspectives that include or do not include historical, cultural, social, and political processes. Aesthetics and the organization of its symbolic process are treated, taking into account expressive activity. The last part of the article explores the notion of aesthetics in applied theater, more specifically in the theater show. Taking the postmodern approach that aesthetics applies to the creation of an artifact and the reception of that artifact, the intervention of these elements in the theatrical system must be emphasized –that is, the analysis of the problems arising in the stages of the creation, presentation, and reception, by the public, of the theater performance. The aesthetic process is triggered involuntarily, simultaneously, or before the moment when people perceive the meaning of the messages transmitted by the work of art. The finding of this fact makes the mental process of aesthetics similar or related to that of semiotics. No matter how perceived individually, beauty, the mechanism of production can be reduced to two. The first step presents similarities to Peirce’s model, but the process between signified and signified additionally stimulates the related memory of the evaluation of beauty, adding to the meanings related to the signification itself. Then, the second step, a process of comparison, is followed, in which one examines whether the object being looked at matches the accumulated memory of beauty. Therefore, even though aesthetics is derived from the conceptual part, the judgment of beauty and, more than that, moral judgment come to be so important to the social activities of human beings that it evolves as a visible process independent of other conceptual contents.

Keywords: aesthetics, semiotics, symbolic composition, subjective joints, signifying, signified

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907 Stuttering Persistence in Children: Effectiveness of the Psicodizione Method in a Small Italian Cohort

Authors: Corinna Zeli, Silvia Calati, Marco Simeoni, Chiara Comastri

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Developmental stuttering affects about 10% of preschool children; although the high percentage of natural recovery, a quarter of them will become an adult who stutters. An effective early intervention should help those children with high persistence risk for the future. The Psicodizione method for early stuttering is an Italian behavior indirect treatment for preschool children who stutter in which method parents act as good guides for communication, modeling their own fluency. In this study, we give a preliminary measure to evaluate the long-term effectiveness of Psicodizione method on stuttering preschool children with a high persistence risk. Among all Italian children treated with the Psicodizione method between 2018 and 2019, we selected 8 kids with at least 3 high risk persistence factors from the Illinois Prediction Criteria proposed by Yairi and Seery. The factors chosen for the selection were: one parent who stutters (1pt mother; 1.5pt father), male gender, ≥ 4 years old at onset; ≥ 12 months from onset of symptoms before treatment. For this study, the families were contacted after an average period of time of 14,7 months (range 3 - 26 months). Parental reports were gathered with a standard online questionnaire in order to obtain data reflecting fluency from a wide range of the children’s life situations. The minimum worthwhile outcome was set at "mild evidence" in a 5 point Likert scale (1 mild evidence- 5 high severity evidence). A second group of 6 children, among those treated with the Piscodizione method, was selected as high potential for spontaneous remission (low persistence risk). The children in this group had to fulfill all the following criteria: female gender, symptoms for less than 12 months (before treatment), age of onset <4 years old, none of the parents with persistent stuttering. At the time of this follow-up, the children were aged 6–9 years, with a mean of 15 months post-treatment. Among the children in the high persistence risk group, 2 (25%) hadn’t had stutter anymore, and 3 (37,5%) had mild stutter based on parental reports. In the low persistency risk group, the children were aged 4–6 years, with a mean of 14 months post-treatment, and 5 (84%) hadn’t had stutter anymore (for the past 16 months on average).62,5% of children at high risk of persistence after Psicodizione treatment showed mild evidence of stutter at most. 75% of parents confirmed a better fluency than before the treatment. The low persistence risk group seemed to be representative of spontaneous recovery. This study’s design could help to better evaluate the success of the proposed interventions for stuttering preschool children and provides a preliminary measure of the effectiveness of the Psicodizione method on high persistence risk children.

Keywords: early treatment, fluency, preschool children, stuttering

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906 Association between Maternal Personality and Postnatal Mother-to-Infant Bonding

Authors: Tessa Sellis, Marike A. Wierda, Elke Tichelman, Mirjam T. Van Lohuizen, Marjolein Berger, François Schellevis, Claudi Bockting, Lilian Peters, Huib Burger

Abstract:

Introduction: Most women develop a healthy bond with their children, however, adequate mother-to-infant bonding cannot be taken for granted. Mother-to-infant bonding refers to the feelings and emotions experienced by the mother towards her child. It is an ongoing process that starts during pregnancy and develops during the first year postpartum and likely throughout early childhood. The prevalence of inadequate bonding ranges from 7 to 11% in the first weeks postpartum. An impaired mother-to-infant bond can cause long-term complications for both mother and child. Very little research has been conducted on the direct relationship between the personality of the mother and mother-to-infant bonding. This study explores the associations between maternal personality and postnatal mother-to-infant bonding. The main hypothesis is that there is a relationship between neuroticism and mother-to-infant bonding. Methods: Data for this study were used from the Pregnancy Anxiety and Depression Study (2010-2014), which examined symptoms of and risk factors for anxiety or depression during pregnancy and the first year postpartum of 6220 pregnant women who received primary, secondary or tertiary care in the Netherlands. The study was expanded in 2015 to investigate postnatal mother-to-infant bonding. For the current research 3836 participants were included. During the first trimester of gestation, baseline characteristics, as well as personality, were measured through online questionnaires. Personality was measured by the NEO Five Factor Inventory (NEO-FFI), which covers the big five of personality (neuroticism, extraversion, openness, altruism and conscientiousness). Mother-to-infant bonding was measured postpartum by the Postpartum Bonding Questionnaire (PBQ). Univariate linear regression analysis was performed to estimate the associations. Results: 5% of the PBQ-respondents reported impaired bonding. A statistically significant association was found between neuroticism and mother-to-infant bonding (p < .001): mothers scoring higher on neuroticism, reported a lower score on mother-to-infant bonding. In addition, a positive correlation was found between the personality traits extraversion (b: -.081), openness (b: -.014), altruism (b: -.067), conscientiousness (b: -.060) and mother-to-infant bonding. Discussion: This study is one of the first to demonstrate a direct association between the personality of the mother and mother-to-infant bonding. A statistically significant relationship has been found between neuroticism and mother-to-infant bonding, however, the percentage of variance predictable by a personality dimension is very small. This study has examined one part of the multi-factorial topic of mother-to-infant bonding and offers more insight into the rarely investigated and complex matter of mother-to-infant bonding. For midwives, it is important recognize the risks for impaired bonding and subsequently improve policy for women at risk.

Keywords: mother-to-infant bonding, personality, postpartum, pregnancy

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905 Generative Behaviors and Psychological Well-Being in Mexican Elders

Authors: Ana L. Gonzalez-Celis, Edgardo Ruiz-Carrillo, Karina Reyes-Jarquin, Margarita Chavez-Becerra

Abstract:

Since recent decades, the aging has been viewed from a more positive perspective, where is not only about losses and damage, but also about being on a stage where you can enjoy life and live with well-being and quality of life. The challenge to feel better is to find those resources that seniors have. For that reason, psychological well-being has shown interest in the study of the affect and life satisfaction (hedonic well-being), while from a more recent tradition, focus on the development of capabilities and the personal growth, considering both as the main indicators of the quality of life. A resource that can be used in the later age is generativity, which refers to the ability of older people to develop and grow through activities that contribute with the improvement of the context in which they live and participate. In this way the generative interest is understood as a favourable attitude that contribute to the common benefit while strengthening and enriching the social institutions, to ensure continuity between generations and social development. On the other hand, generative behavior, differentiating from generative interest, is the expression of that attitude reflected in activities that make a social contribution and a benefit for generations to come. Hence the purpose of the research was to test if there is an association between the generative behaviour type and the psychological well-being with their dimensions. For this reason 188 Mexican adults from 60 to 94 years old (M = 69.78), 67% women, 33% men, completed two instruments: The Ryff’s Well-Being Scales to measure psychological well-being with 39 items with two dimensions (Hedonic and Eudaimonic well-being), and the Loyola’s Generative Behaviors Scale, grouped in five categories: Knowledge transmitted to the next generation, things to be remember, creativity, be productive, contribution to the community, and responsibility of other people. In addition, the socio-demographic data sheet was tested, and self-reported health status. The results indicated that the psychological well-being and its dimensions were significantly associated with the presence of generative behavior, where the level of well-being was higher when the frequency of some generative behaviour excelled; finding that the behavior with greater psychological well-being (M = 81.04, SD = 8.18) was "things to be remembered"; while with greater hedonic well-being (M = 73.39, SD = 12.19) was the behavior "responsibility of other people"; and with greater Eudaimonic well-being (M = 84.61, SD = 6.63), was the behavior "things to be remembered”. The most important findings highlight the importance of generative behaviors in adulthood, finding empirical evidence that the generativity in the last stage of life is associated with well-being. However, by finding differences in the types of generative behaviors at the level of well-being, is proposed the idea that generativity is not situated as an isolated construct, but needs other contextualized and related constructs that can simultaneously operate at different levels, taking into account the relationship between the environment and the individual, encompassing both the social and psychological dimension.

Keywords: eudaimonic well-being, generativity, hedonic well-being, Mexican elders, psychological well-being

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

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

Abstract:

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

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

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903 Effect of Self-Lubricating Carbon Materials on the Tribological Performance of Ultra-High Molecular Weight Polyethylene

Authors: Nayeli Camacho, Fernanda Lara-Perez, Carolina Ortega-Portilla, Diego G. Espinosa-Arbelaez, Juan M. Alvarado-Orozco, Guillermo C. Mondragon-Rodriguez

Abstract:

Ultra-high molecular weight polyethylene (UHMWPE) has been the gold standard material for total knee replacements for almost five decades. Wear damage to UHMWPE articulating surface is inevitable due to the natural sliding and rolling movements of the knee. This generates a considerable amount of wear debris, which results in mechanical instability of the joint, reduces joint mobility, increases pain with detrimental biologic responses, and causes component loosening. The presence of wear particles has been closely related to adverse reactions in the knee joint surrounding tissue, especially for particles in the range of 0.3 to 2 μm. Carbon-based materials possess excellent mechanical properties and have shown great promise in tribological applications. In this study, diamond-like carbon coatings (DLC) and carbon nanotubes (CNTs) were used to decrease the wear rate of ultra-high molecular weight polyethylene. A titanium doped DLC (Ti-DLC) was deposited by magnetron sputtering on stainless steel precision spheres while CNTs were used as a second phase reinforcement in UHMWPE at a concentration of 1.25 wt.%. A comparative tribological analysis of the wear of UHMWPE and UHMWPE-CNTs with a stainless steel counterpart with and without Ti-DLC coating is presented. The experimental wear testing was performed on a pin-on-disc tribometer under dry conditions, using a reciprocating movement with a load of 1 N at a frequency of 2 Hz for 100,000 and 200,000 cycles. The wear tracks were analyzed with high-resolution scanning electron microscopy to determine wear modes and observe the size and shape of the wear debris. Furthermore, profilometry was used to study the depth of the wear tracks and to map the wear of the articulating surface. The wear tracks at 100,000 and 200,000 cycles on all samples were relatively shallow, and they were in the range of average roughness. It was observed that the Ti-DLC coating decreases the mass loss in the UHMWPE and the depth of the wear track. The combination of both carbon-based materials decreased the material loss compared to the system of stainless steel and UHMWPE. Burnishing of the surface was the predominant wear mode observed with all the systems, more subtle for the systems with Ti-DLC coatings. Meanwhile, in the system composed of stainless steel-UHMWPE, the intrinsic surface roughness of the material was completely replaced by the wear tracks.

Keywords: CNT reinforcement, self-lubricating materials, Ti-DLC, UHMWPE tribological performance

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