Search results for: accessibility score

Authors: Gintare Judzentyte

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The present research is aimed to discuss semantics and pragmatics of spatial deictics (deictic adverbs of place and demonstrative pronouns) in the Baltic languages: in spoken Lithuanian and in spoken Latvian. The following objectives have been identified to achieve the aim: 1) to determine the usage of adverbs of place in spoken Lithuanian and Latvian and to verify their meanings in face-to-face communication; 2) to determine the usage of demonstrative pronouns in spoken Lithuanian and Latvian and to verify their meanings in face-to-face communication; 3) to compare the systems between the two spoken languages and to identify the main tendencies. As meanings of demonstratives (adverbs of place and demonstrative pronouns) are context-bound, it is necessary to verify their usage in spontaneous interaction. Besides, deictic gestures play a very important role in face-to-face communication. Therefore, an experimental method is necessary to collect the data. Video material representing spoken Lithuanian and spoken Latvian was recorded by means of the method of a qualitative interview (a semi-structured interview: an empirical research is all about asking right questions). The collected material was transcribed and evaluated taking into account several approaches: 1) physical distance (location of the referent, visual accessibility of the referent); 2) deictic gestures (the combination of language and gesture is especially characteristic of the exophoric use); 3) representation of mental spaces in physical space (a speaker sometimes wishes to mark something that is psychically close as psychologically distant and vice versa). The research of the collected data revealed that in face-to-face communication the participants choose deictic adverbs of place instead of demonstrative pronouns to locate/identify entities in situations where the demonstrative pronouns would be expected in spoken Lithuanian and in spoken Latvian. The analysis showed that visual accessibility of the referent is very important in face-to-face communication, but the main criterion while localizing objects and entities is the need for contrast: lith. čia ‘here’, šis ‘this’, latv. šeit ‘here’, šis ‘this’ usually identify distant entities and are used instead of distal demonstratives (lith. ten ‘there’, tas ‘that’, latv. tur ‘there’, tas ‘that’), because the referred objects/subjects contrast to further entities. Furthermore, the interlocutors in examples from a spontaneously situated interaction usually extend their space and can refer to a ‘distal’ object/subject with a ‘proximal’ demonstrative based on the psychological choice. As the research of the spoken Baltic languages confirmed, the choice of spatial deictics in face-to-face communication is strongly effected by a complex of criteria. Although there are some main tendencies, the exact meaning of spatial deictics in the spoken Baltic languages is revealed and is relevant only in a certain context.

Keywords: Baltic languages, face-to-face communication, pragmatics, semantics, spatial deictics

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Authors: Jong Yeop Kim, In Kyong Yi, Hyun Jeong Kwak, Sook Young Lee, Sung Yong Park

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Background: Several video laryngoscopes (VLs) were used to facilitate tracheal intubation in the normal and potentially difficult airway, especially by novice personnel. The aim of this study was to compare tracheal intubation performance regarding the time to intubation, glottic view, difficulty, and dental click, by a novice using McGrath VL, Pentax Airway Scope (AWS) and Macintosh laryngoscope in normal and cervical immobilized manikin models. Methods: Thirty-five anesthesia nurses without previous intubation experience were recruited. The participants performed endotracheal intubation in a manikin model at two simulated neck positions (normal and fixed neck via cervical immobilization), using three different devices (McGrath VL, Pentax AWS, and Macintosh direct laryngoscope) at three times each. Performance parameters included intubation time, success rate of intubation, Cormack Lehane laryngoscope grading, dental click, and subjective difficulty score. Results: Intubation time and success rate at the first attempt were not significantly different between the 3 groups in normal airway manikin. In the cervical immobilized manikin, the intubation time was shorter (p = 0.012) and the success rate with the first attempt was significantly higher (p < 0.001) when using McGrath VL and Pentax AWS compared with Macintosh laryngoscope. Both VLs showed less difficulty score (p < 0.001) and more Cormack Lehane grade I (p < 0.001). The incidence of dental clicks was higher with McGrath VL than Macintosh laryngoscope in the normal and cervical immobilized airway (p = 0.005, p < 0.001, respectively). Conclusion: McGrath VL and Pentax AWS resulted in shorter intubation time, higher first attempt success rate, compared with Macintosh laryngoscope by a novice intubator in a cervical immobilized manikin model. McGrath VL could be reduced the risk of dental injury compared with Macintosh laryngoscope in this scenario.

Keywords: intubation, manikin, novice, videolaryngoscope

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Authors: Mohamed Hendawy Mousa, Warda Youssef Mohamed Morsy

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Background: Sepsis is a major cause of mortality and morbidity in trauma patients. Body mass index as an indicator of nutritional status was reported as a predictor of injury pattern and complications among critically ill injured patients. Aim: The aim of this study is to investigate the relationship between body mass index and the development of sepsis, systemic inflammatory response syndrome among adult trauma patients at emergency hospital - Cairo University. Research design: Descriptive correlational research design was utilized in the current study. Research questions: Q1. What is the body mass index profile of adult trauma patients admitted to the emergency hospital at Cairo University over a period of 6 months?, Q2. What is the frequency of systemic inflammatory response syndrome and sepsis among adult trauma patients admitted to the emergency hospital at Cairo University over a period of 6 months?, and Q3. What is the relationship between the development of sepsis, systemic inflammatory response syndrome and body mass index among adult trauma patients admitted to the emergency hospital at Cairo University over a period of 6 months?. Sample: A purposive sample of 52 adult male and female trauma patients with revised trauma score 10 to 12. Setting: The Emergency Hospital affiliated to Cairo University. Tools: Four tools were utilized to collect data pertinent to the study: Socio demographic and medical data tool, Systemic inflammatory response syndrome assessment tool, Revised Trauma Score tool, and Sequential organ failure assessment tool. Results: The current study revealed that, (61.5 %) of the studied subjects had normal body mass index, (25 %) were overweight, and (13.5 %) were underweight. 84.6% of the studied subjects had systemic inflammatory response syndrome and 92.3% were suffering from mild sepsis. No significant statistical relationship was found between body mass index and occurrence of Systemic inflammatory response syndrome (2= 2.89 & P = 0.23). However, Sequential organ failure assessment scores were affected significantly by body mass index was found mean of initial and last Sequential organ failure assessment score for underweight, normal and obese where t= 7.24 at p = 0.000, t= 16.49 at p = 0.000 and t= 9.80 at p = 0.000 respectively. Conclusion: Underweight trauma patients showed significantly higher rate of developing sepsis as compared to patients with normal body weight and obese. Recommendations: based on finding of this study the following are recommended: replication of the study on a larger probability sample from different geographical locations in Egypt; Carrying out of further studies in order to assess the other risk factors influencing trauma outcome and incidence of its complications; Establishment of standardized guidelines for managing underweight traumatized patients with sepsis.

Keywords: body mass index, sepsis, systemic inflammatory response syndrome, adult trauma

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Authors: Domenica Tambasco, Riina Bray, Sophia Jaworski, Gillian Grant, Celeste Corkery

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Fibromyalgia is a chronic condition characterized by widespread musculoskeletal pain, fatigue, and reduced function. Management of symptoms include medications, physical treatments and mindfulness therapies. Myofascial Release is a modality that has been successfully applied in var-ious musculoskeletal conditions. However, to the author’s best knowledge, it is not yet recog-nized as a self-management therapy option in Fibromyalgia. In this study, we investigated whether Self-applied Myofascial Release (SMR) is associated with overall improved function and symptoms in Fibromyalgia. Methods: Eligible adult patients with a confirmed diagnosis of Fibromyalgia at Women’s College Hospital were recruited to SMR. Sessions ran for 1 hour once a week for 7 weeks, led by the same two Physiotherapists knowledgeable in this physical treat-ment modality. The main outcome measure was an overall impact score for function and symp-toms based on the validated assessment tool for Fibromyalgia, the Revised Fibromyalgia Impact Questionnaire (FIQR), measured pre and post-intervention. Both descriptive and analytical methods were applied and reported. Results: We analyzed results using a paired t-test to deter-mine if there was a statistically significant difference in mean FIQR scores between initial (pre-intervention) and final (post-intervention) scores. A clinically significant difference in FIQR was defined as a reduction in score by 10 or more points. Conclusions: Our pilot study showed that SMR appeared to be a safe and effective intervention for our Fibromyalgia participants and the overall impact on function and symptoms occurred in only 7 weeks. Further studies with larger sample sizes comparing SMR to other physical treatment modalities (such as stretching) in an RCT are recommended.

Keywords: fibromyalgia, myofascial release, physical therapy, FIQR

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Authors: J. Luché-Thayer, C. Perronne, C. Meseko

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We reviewed how certain institutional policies and practices, as well as questionable research, are creating obstacles to care and informed consent for Lyme and relapsing fever Borreliosis patients. The interference is denying access to treatments that meet the internationally accepted standards as set by the Institute of Medicine. This obstruction to care contributes to significant human suffering, disability and negative economic effect across many nations and in many regions of the world. We note how evidence based medicine emphasizes the importance of clinical experience and patient-centered care and how these patients benefit significantly when their rights to choose among treatment options are upheld.  

Keywords: conflicts of interest, obstacles to healthcare accessibility, patient-centered care, the right to informed consent

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Authors: Yong Hwang, Kang Yeol Suh, Yundeok Jang, Tae Hoon Kim

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Introduction: Rhabdomyolysis is a syndrome characterized by muscle necrosis and the release of intracellular muscle constituents into the circulation. Acute kidney injury is a potential complication of severe rhabdomyolysis and the prognosis is substantially worse if renal failure develops. We try to identify the factors that were predictive of AKI in severe trauma patients with rhabdomyolysis. Methods: This retrospective study was conducted at the emergency department of a level Ⅰ trauma center. Patients enrolled that initial creatine phosphokinase (CPK) levels were higher than 1000 IU with acute multiple trauma, and more than 18 years older from Oct. 2012 to June 2016. We collected demographic data (age, gender, length of hospital day, and patients’ outcome), laboratory data (ABGA, lactate, hemoglobin. hematocrit, platelet, LDH, myoglobin, liver enzyme, and BUN/Cr), and clinical data (Injury Mechanism, RTS, ISS, AIS, and TRISS). The data were compared and analyzed between AKI and Non-AKI group. Statistical analyses were performed using IMB SPSS 20.0 statistics for Window. Results: Three hundred sixty-four patients were enrolled that AKI group were ninety-six and non-AKI group were two hundred sixty-eight. The base excess (HCO3), AST/ALT, LDH, and myoglobin in AKI group were significantly higher than non-AKI group from laboratory data (p ≤ 0.05). The injury severity score (ISS), revised Trauma Score (RTS), Abbreviated Injury Scale 3 and 4 (AIS 3 and 4) were showed significant results in clinical data. The patterns of CPK level were increased from first and second day, but slightly decreased from third day in both group. Seven patients had received hemodialysis treatment despite the bleeding risk and were survived in AKI group. Conclusion: We recommend that HCO3, CPK, LDH, and myoglobin should be checked and be concerned about ISS, RTS, AIS with injury mechanism at the early stage of treatment in the emergency department.

Keywords: acute kidney injury, emergencies, multiple trauma, rhabdomyolysis

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Authors: Xin Chen, Xiao Yang, Rongrong Han, Lu Chen, Lingling Gao

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Background: Leisure time physical activity (LTPA) benefits both pregnant women and their fetuses. The guidelines recommended that pregnant women should do at least 150 minutes of moderate-intensity aerobic physical activity throughout the week. The aim of this study was to investigate the rate of LTPA participation among Chinese pregnant women and to identify its predictors based on the health belief model. Methods: A cross-sectional study was conducted from June 2019 to September 2019 in Changchun, China. A total of 225 pregnant women aged 18 years or older with no severe physical or mental disease were recruited in the obstetric clinic. Self-administered questionnaires were used to collect data. LTPA was assessed by a pregnant physical activity questionnaire (PPAQ). A revised pregnancy physical activity health belief scale and social-demographic and perinatal characteristics factors were collected and used to predict LTPA participation. Data were analyzed using descriptive statistics and multivariate logistic regression. Results: The participants had a high level of perceived susceptibility, perceived severity, perceived benefits, and action clues, with mean item scores above 3.5. The predictors of LTPA in Chinese pregnant women were pre-pregnancy exercise habits [OR 3.236 (95% CI:1.632, 6.416)], perceived susceptibility score [OR 2.083 (95% CI:1.002, 4.331)], and perceived barriers score [OR 3.113 (95%CI:1.462, 6.626)]. Conclusions: The results of this study will lead to better identification of pregnant women who may not participate in LTPA. Healthcare professionals should be cognizant of issues that may affect LTPA participation among pregnant women, including pre-pregnancy exercise habits, perceived susceptibility, and perceived barriers.

Keywords: pregnancy, health belief model., leisure time physical activity, factors

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Authors: Sofia Papadimitriou

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INTRODUCTION: The differential diagnosis between acute viral and bacterial infections is an important cost-effectiveness parameter at the stage of the treatment process in order to achieve the maximum benefits in therapeutic intervention by combining the minimum cost to ensure the proper use of antibiotics.The discovery of sensitive and robust molecular diagnostic tests in response to the role of the host in infections has enhanced the accurate diagnosis and differentiation of infections. METHOD: The study used a sample of six independent blood samples (total=756) which are associated with human proteins-proteins, each of which at the transcription stage expresses a different response in the host network between viral and bacterial infections.Τhe individual blood samples are subjected to a sequence of computer filters that identify a gene panel corresponding to an autonomous diagnostic score. The data set and the correspondence of the gene panel to the diagnostic patents a new Bangalore -Viral Bacterial (BL-VB). FINDING: We use a biomarker based on the blood of 10 genes(Panel-VB) that are an important prognostic value for the detection of viruses from bacterial infections with a weighted average AUROC of 0.97(95% CL:0.96-0.99) in eleven independent samples (sets n=898). We discovered a base with a patient score (VB 10 ) according to the table, which is a significant diagnostic value with a weighted average of AUROC 0.94(95% CL: 0.91-0.98) in 2996 patient samples from 56 public sets of data from 19 different countries. We also studied VB 10 in a new cohort of South India (BL-VB,n=56) and found 97% accuracy in confirmed cases of viral and bacterial infections. We found that VB 10 (a)accurately identifies the type of infection even in unspecified cases negative to the culture (b) shows its clinical condition recovery and (c) applies to all age groups, covering a wide range of acute bacterial and viral infectious, including non-specific pathogens. We applied our VB 10 rating to publicly available COVID 19 data and found that our rating diagnosed viral infection in patient samples. RESULTS: Τhe results of the study showed the diagnostic power of the biomarker VB 10 as a diagnostic test for the accurate diagnosis of acute infections in recovery conditions. We look forward to helping you make clinical decisions about prescribing antibiotics and integrating them into your policies management of antibiotic stewardship efforts. CONCLUSIONS: Overall, we are developing a new property of the RNA-based biomarker and a new blood test to differentiate between viral and bacterial infections to assist a physician in designing the optimal treatment regimen to contribute to the proper use of antibiotics and reduce the burden on antimicrobial resistance, AMR.

Keywords: acute infections, antimicrobial resistance, biomarker, blood transcriptome, systems biology, classifier diagnostic score

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Authors: Nkechinyere Joy Olawuyi, Babajide Samuel Afolabi, Bola Ibitoye

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This study collected a preprocessed dataset of chest radiographs and formulated a deep neural network model for detecting abnormalities. It also evaluated the performance of the formulated model and implemented a prototype of the formulated model. This was with the view to developing a deep neural network model to automatically classify abnormalities in chest radiographs. In order to achieve the overall purpose of this research, a large set of chest x-ray images were sourced for and collected from the CheXpert dataset, which is an online repository of annotated chest radiographs compiled by the Machine Learning Research Group, Stanford University. The chest radiographs were preprocessed into a format that can be fed into a deep neural network. The preprocessing techniques used were standardization and normalization. The classification problem was formulated as a multi-label binary classification model, which used convolutional neural network architecture to make a decision on whether an abnormality was present or not in the chest radiographs. The classification model was evaluated using specificity, sensitivity, and Area Under Curve (AUC) score as the parameter. A prototype of the classification model was implemented using Keras Open source deep learning framework in Python Programming Language. The AUC ROC curve of the model was able to classify Atelestasis, Support devices, Pleural effusion, Pneumonia, A normal CXR (no finding), Pneumothorax, and Consolidation. However, Lung opacity and Cardiomegaly had a probability of less than 0.5 and thus were classified as absent. Precision, recall, and F1 score values were 0.78; this implies that the number of False Positive and False Negative is the same, revealing some measure of label imbalance in the dataset. The study concluded that the developed model is sufficient to classify abnormalities present in chest radiographs into present or absent.

Keywords: transfer learning, convolutional neural network, radiograph, classification, multi-label

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Authors: F. Benhamida, A. Graa, L. Benameur, I. Ziane

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The state estimation of the electrical power system operation state is very important for supervising task. With the nonlinearity of the AC power flow model, the state estimation problem (SEP) is a nonlinear mathematical problem with many local optima. This paper treat the mathematical model for the SEP and the monitoring of the nonlinear systems of great dimensions with an application on power electrical system, the modelling, the analysis and state estimation synthesis in order to supervise the power system behavior. in fact, it is very difficult, to see impossible, (for reasons of accessibility, techniques and/or of cost) to measure the excessive number of the variables of state in a large-sized system. It is thus important to develop software sensors being able to produce a reliable estimate of the variables necessary for the diagnosis and also for the control.

Keywords: power system, state estimation, robustness, observability

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Authors: Kalaashini Ramachandran, Maznah Dahlui, Nik Daliana Nik Farid

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WHO recommends all babies to be exclusively breastfed and donor milk is the next best alternative in the absence of mother’s own milk. The establishment of a human milk bank (HMB) is still being debated due to religious concerns in Malaysia leading to informal milk sharing practices, but little is known on the knowledge, attitude and perception of women towards HMB and its benefits. This study hypothesizes that there is no association between knowledge and attitude and the acceptance towards the establishment of human milk bank among Malaysian women and healthcare providers. The aim of this study is to determine the drivers and barriers among Malaysian towards the acceptance of an HMB. A cross-sectional study with 367 participants was enrolled within a period of 3 months to answer an online self-administered questionnaire. Data on sociodemographic, knowledge on breastfeeding benefits, knowledge and attitude on HMB and its specific issues were analyzed in terms of frequency and then proceed to multiple logistic regression. Majority of the respondents are of Islamis religion (73.3%), have succeesfully completed their tertiary education (82.8%), and are employed (70.8%). Only 55.9% of respondents have heard of an HMB stating internet as their main source of information but a higher prevalence is agreeable to the establishment of a human milk bank (67.8%). Most respondents have a good score on knowledge of breastfeeding benefits and on HMB specific issues (70% and 54.2% respectively) while 63.8% of them have a positive attitude towards HMB. In the multivariate analysis, mothers with a good score on general knowledge of breastfeeding (AOR: 1.715) were more likely to accept the establishment of an HMB while Islamic religion was negatively associated with its establishment (AOR:0.113). This study has found a high prevalence rate of mothers who are willing to accept the establishment of an HMB. This action can be potentially shaped by educating mothers on the benefits of breastfeeding as well as addressing their religious concerns so the establishment of a religiously abiding HMB in Malaysia may be accepted without compromising their belief or the health benefit of donor milk.

Keywords: acceptability, attitude, human milk bank, knowledge

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Authors: Waleed Aly Sayed Ahmed, Eman Kishk, Tahani Shams

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Aim: To study the effects of co-administration of phosphodiesterase-5 inhibitor (PDE-5) and sodium selenite against the damage induced by ovarian ischemia-reperfusion in rats. Materials and Methods: A total of forty-two sexually mature, virgin, female rats were divided randomly into six groups of seven each: sham group (C), ischemia group (I), ischemia/reperfusion group (I/R), ischemia/reperfusion plus 1.4mg/kg sildenafil (I/R+S) group, ischemia/reperfusion plus 0.2mg/kg selenium (I/R+Se) group and ischemia/reperfusion plus combination of sildenafil and selenium (I/R+S+Se) group. In ischemia group (I), rats were exposed to ischemia for 3 hours (h). In ischemia/reperfusion group (I/R), rats were exposed to ischemia for 3 h followed by 6 h of reperfusion. Treated groups received 1.4mg/kg sildenafil or 0.2 mg/kg selenium or both 30 min before reperfusion. Both ovaries were surgically removed carefully. One ovary was examined for histopathological changes and the other was subject to biochemical analysis including malondialdehyde (MDA), catalase (CAT) and glutathione peroxidase (GPx). Results: Assessment of ovarian tissue damage using a scoring system showed marked vascular congestion, interstitial edema, leukocyte infiltration, hemorrhage, and follicular degeneration in ischemia and ischemia/reperfusion groups. Tissue damage score for I, IR and all treated groups were significantly higher than those of the sham group (p<0.001), while tissue damage score decreased significantly in I/R+S and I/R+Se groups compared to I/R group (p<0.05), and notably, the difference was highly significant in I/R+S+Se group (p<0.001). There was significant increase in MDA levels and reduction in activities of CAT and GPx in I/R group compared to the sham group (p < 0.05). In I/R+S and I/R+Se groups, MDA was significantly decreased compared to the I/R group (p<0.05) and the difference was highly significant with co-administration of sildenafil and selenium (p<0.001). CAT and GPx were higher in all treated groups compared to I/R group (p<0.05). Conclusion: The co-administration of sildenafil citrate and selenium are highly protective against damage induced by ovarian ischemia/reperfusion in rats.

Keywords: phosphodiesterase-5 inhibitor, sildenafil, antioxidant, selenium, ovarian ischemia

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Authors: Y. Trantafyllou, C. Alexandraki

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Music interpretation accounts to the way musicians shape their performance by deliberately deviating from composers’ intentions, which are commonly communicated via some form of music transcription, such as a music score. For transcribed and non-improvised music, music expression is manifested by introducing subtle deviations in tempo, dynamics and articulation during the evolution of performance. This paper presents an application, named FlameCens, which, given two recordings of the same piece of music, presumably performed by different musicians, allow visualising deviations in tempo and dynamics during playback. The application may also compare a certain performance to the music score of that piece (i.e. MIDI file), which may be thought of as an expression-neutral representation of that piece, hence depicting the expressive queues employed by certain performers. FlameCens uses the Dynamic Time Warping algorithm to compare two audio sequences, based on CENS (Chroma Energy distribution Normalized Statistics) audio features. Expressive deviations are illustrated in a moving flame, which is generated by an animation of particles. The length of the flame is mapped to deviations in dynamics, while the slope of the flame is mapped to tempo deviations so that faster tempo changes the slope to the right and slower tempo changes the slope to the left. Constant slope signifies no tempo deviation. The detected deviations in tempo and dynamics can be additionally recorded in a text file, which allows for offline investigation. Moreover, in the case of monophonic music, the color of particles is used to convey the pitch of the notes during performance. FlameCens has been implemented in Python and it is openly available via GitHub. The application has been experimentally validated for different music genres including classical, contemporary, jazz and popular music. These experiments revealed that FlameCens can be a valuable tool for music specialists (i.e. musicians or musicologists) to investigate the expressive performance strategies employed by different musicians, as well as for music audience to enhance their listening experience.

Keywords: audio synchronization, computational music analysis, expressive music performance, information visualization

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Authors: F. Pagliara, F. Mauriello

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The objective of this paper is to investigate the relationship between the increase of accessibility brought by high speed rail (HSR) systems and the tourism market in Italy. The impacts of HSR projects on tourism can be quantified in different ways. In this manuscript, an empirical analysis has been carried out with the aid of a dataset containing information both on tourism and transport for 99 Italian provinces during the 2006-2016 period. Panel data regression models have been considered, since they allow modelling a wide variety of correlation patterns. Results show that HSR has an impact on the choice of a given destination for Italian tourists while the presence of a second level hub mainly affects foreign tourists. Attraction variables are also significant for both categories and the variables concerning security, such as number of crimes registered in a given destination, have a negative impact on the choice of a destination.

Keywords: tourists, overnights, high speed rail, attractions, security

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Authors: Gelareh Ghaderi

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the overall objective of this study is to develop two alternative plans of spatial and infrastructural development for the Netwerkstad Twente (Twente region) until 2040 and to assess the impacts of those two alternative plans. This region is located on the eastern border of the Netherlands, and it comprises of five municipalities. Based on the strengths and opportunities of the five municipalities of the Netwerkstad Twente, and in order develop the region internationally, strengthen the job market and retain skilled and knowledgeable young population, two alternative visions have been developed; environmental oriented vision, and economical oriented vision. Environmental oriented vision is based mostly on preserving beautiful landscapes. Twente would be recognized as an educational center, driven by green technologies and environment-friendly economy. Market-oriented vision is based on attracting and developing different economic activities in the region based on visions of the five cities of Netwerkstad Twente, in order to improve the competitiveness of the region in national and international scale. On the basis of the two developed visions and strategies for achieving the visions, land use and infrastructural development are modeled and assessed. Based on the SWOT analysis, criteria were formulated and employed in modeling the two contrasting land use visions by the year 2040. Land use modeling consists of determination of future land use demand, assessment of suitability land (Suitability analysis), and allocation of land uses on suitable land. Suitability analysis aims to determine the available supply of land for future development as well as assessing their suitability for specific type of land uses on the basis of the formulated set of criteria. Suitability analysis was operated using CommunityViz, a Planning Support System application for spatially explicit land suitability and allocation. Netwerkstad Twente has highly developed transportation infrastructure, consists of highways network, national road network, regional road network, street network, local road network, railway network and bike-path network. Based on the assumptions of speed limitations on different types of roads provided, infrastructure accessibility level of predicted land use parcels by four different transport modes is investigated. For evaluation of the two development scenarios, the Multi-criteria Evaluation (MCE) method is used. The first step was to determine criteria used for evaluation of each vision. All factors were categorized as economical, ecological and social. Results of Multi-criteria Evaluation show that Environmental oriented cities scenario has higher overall score. Environment-oriented scenario has impressive scores in relation to economical and ecological factors. This is due to the fact that a large percentage of housing tends towards compact housing. Twente region has immense potential, and the success of this project will define the Eastern part of The Netherlands and create a real competitive local economy with innovations and attractive environment as its backbone.

Keywords: economical oriented vision, environmental oriented vision, infrastructure, land use, multi criteria assesment, vision

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Authors: Ali Abdi Kordani, Hamid Bigdelirad, Sid Mohammad Boroomandrad

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Operating Urban Bus Transit System is a phenomenon that has a major role in transporting passengers in cities. There are many factors involved in planning and operating an Urban Bus Transit System, one of which is selecting optimized number of stops and scheduling of bus fleet departure. In this paper, we tried to introduce desirable methodology to select number of stops and schedule properly. Selecting the right number of stops causes convenience in accessibility and reduction in travel time and finally increase in public preference of this transportation mode. The achieved results revealed that number of stops must reduce from 33 to 25. Also according to scheduling and conducted economic analysis, the number of buses must decrease from 17 to 11 to have the most appropriate status for the Bus Organization.

Keywords: number of optimized stops, organizing bus system, scheduling, urban transit

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Authors: Rezvan Hosseinian

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Aim: Systemic sclerosis (SSc) is a chronic connective tissue disease with the clinical hallmark of skin thickening and tethering. The correlation of musculoskeletal features with other parameters should be considered in SSc patients. Methods: We reviewed the records of all patients who had more than one visit and standard anteroposterior radiography of hand. We used univariate analysis, and factors with p<0.05 were included in logistic regression to find out dependent factors. Results: Overall, 180 SSc patients were enrolled in our study, 161 (89.4%) of whom were women. The median age (IQR) was 47.0 years (16), and 52% had a diffuse subtype of the disease. In multivariate analysis, tendon friction rubs (TFRs) were associated with the presence of calcinosis, muscle tenderness, and flexion contracture (FC) on physical examination (p<0.05). Arthritis showed no differences in the two subtypes of the disease (p=0.98), and in multivariate analysis, there were no correlations between radiographic arthritis and serological and clinical features. The radiographic results indicated that disease duration correlated with joint erosion, acro-osteolysis, resorption of the distal ulna, calcinosis and radiologic FC (p< 0.05). Acro-osteolysis was more frequent in the dcSSc subtype, TFRs, and anti-TOPO I antibody. Radiologic FC showed an association with skin score, calcinosis and haematocrit <30% (p<0.05). Joint flexion on radiography was associated with disease duration, modified Rodnan skin score, calcinosis, and low hematocrit (P<0.01). Conclusion: Disease duration was a main dependent factor for developing joint erosion, acro-osteolysis, bone resorption, calcinosis, and flexion contracture on hand radiography. Acro-osteolysis presented in the severe form of the disease. Acro-osteolysis was the only dependent variable associated with bone demineralization.

Keywords: disease subsets, hand radiography, joint erosion, sclerosis

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Authors: Nasrin Azarbani

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Aim: Systemic sclerosis (SSc) is a chronic connective tissue disease with the clinical hallmark of skin thickening and tethering. Correlation of musculoskeletal features with other parameters should be considered in SSc patients. Methods: We reviewed the records of all patients who had more than one visit and standard anteroposterior radiography of hand. We used univariate analysis, and factors with p<0.05 were included in logistic regression to find out dependent factors. Results: Overall, 180 SSc patients were enrolled in our study, 161 (89.4%) of whom were women. Median age (IQR) was 47.0 years (16), and 52% had diffuse subtype of the disease. In multivariate analysis, tendon friction rubs (TFRs) was associated with the presence of calcinosis, muscle tenderness, and flexion contracture (FC) on physical examination (p<0.05). Arthritis showed no differences in the two subtypes of the disease (p=0.98), and in multivariate analysis, there were no correlations between radiographic arthritis and serological and clinical features. The radiographic results indicated that disease duration correlated with joint erosion, acro-osteolysis, resorption of distal ulna, calcinosis and radiologic FC (p< 0.05). Acro-osteolysis was more frequent in the dcSSc subtype, TFRs, and anti-TOPO I antibody. Radiologic FC showed an association with skin score, calcinosis and haematocrit <30% (p<0.05). Joint flexion on radiography was associated with disease duration, modified Rodnan skin score, calcinosis, and low haematocrit (P<0.01). Conclusion: Disease duration was a main dependent factor for developing joint erosion, acro-osteolysis, bone resorption, calcinosis, and flexion contracture on hand radiography. Acro-osteolysis presented in the severe form of the disease. Acro-osteolysis was the only dependent variable associated with bone demineralization.

Keywords: sclerosis, disease subsets, joint erosion, musculoskeletal

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Authors: Muhammad Tufail, Jawad Hussain, Hammad Hussain, Imran Hafeez, Naveed Ahmad

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Road safety performance index is a composite index which combines various indicators of road safety into single number. Development of a road safety performance index using appropriate safety performance indicators is essential to enhance road safety. However, a road safety performance index in developing countries has not been given as much priority as needed. The primary objective of this research is to develop a general Road Safety Performance Index (RSPI) for developing countries based on the facility as well as behavior of road user. The secondary objectives include finding the critical inputs in the RSPI and finding the better method of making the index. In this study, the RSPI is developed by selecting four main safety performance indicators i.e., protective system (seat belt, helmet etc.), road (road width, signalized intersections, number of lanes, speed limit), number of pedestrians, and number of vehicles. Data on these four safety performance indicators were collected using observation survey on a 20 km road section of the National Highway N-125 road Taxila, Pakistan. For the development of this composite index, two methods are used: a) Principal Component Analysis (PCA) and b) Equal Weighting (EW) method. PCA is used for extraction, weighting, and linear aggregation of indicators to obtain a single value. An individual index score was calculated for each road section by multiplication of weights and standardized values of each safety performance indicator. However, Simple Average technique was used for weighting and linear aggregation of indicators to develop a RSPI. The road sections are ranked according to RSPI scores using both methods. The two weighting methods are compared, and the PCA method is found to be much more reliable than the Simple Average Technique.

Keywords: indicators, aggregation, principle component analysis, weighting, index score

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Authors: Krishna Dahiya

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Introduction: Labour pain has been described as the most severe pain experienced by women in their lives. Pain management in labour is one of the most important challenges faced by the obstetrician. The opioids are the primary treatment for patients with moderate and severe pain but these drugs are not always tolerated and are associated with dose-dependent side effects. Nonsteroidal anti-inflammatory drugs, too, are associated with variable adverse effects. Considering these factors, our study compared the efficacy and side effect of intravenous tramadol and paracetamol. Objective: To evaluate the efficacy and adverse effects of an intravenous infusion of 1000 mg of paracetamol as compared with an intravenous injection of 50mg of tramadol for intrapartum analgesia. Methods: In a randomized prospective study at Pt. BDS PGIMS, 200 women in active labor were allocated to received either paracetamol (n=100) or tramadol (n=100). The primary outcome was the efficacy of the drug to supply adequate analgesia as measured by a change in the visual analog scale (VAS) pain intensity score at various times after drug administration. The secondary outcomes included the need for additional rescue analgesia and the presence of adverse maternal or fetal events. Results: The mean age of cases were 25.55 ± 3.849 years and 25.60 ± 3.655 years respectively As recorded by the VAS score, there was significant pain reduction at 30 minutes, and at 1 and 2 hours in both groups (P<0.01). In comparison, between group I and II, a significantly higher rate of nausea and vomiting in tramadol group (14% vs 8%; P < 0.03) patients. Similarly, drowsiness (0% vs 11%; P<0.01), dry mouth (0% vs 8%; P<0.04) and dizziness (0% vs 9%; P<0.02) was also significant in group II. Conclusion: Due to difficulty in administering epidural analgesia to all parturients, administration of paracetamol and tramadol infusion for analgesia is simple and less invasive alternative. In the present study, both paracetamol and tramadol were equally effective for labour analgesia but paracetamol has emerged as safe alternative as compared to tramadol due to a low incidence of side effects.

Keywords: paracetamol, tramadol, labor, analgesia

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Authors: F. O’Dowd, G. Murphy, M. Roche, E. Shudell, F. Keane, M. O’Kane

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Intoduction: Apremilast (Otezla®) is an oral phosphodiesterase-4 (PDE4) inhibitor indicated for treatment of adult patients with moderate to severe plaque psoriasis who have contraindications to have failed or intolerant of standard systemic therapy and/or phototherapy; and adult patients with active psoriatic arthritis. Apremilast influences intracellular regulation of inflammatory mediators. Two randomized, placebo-controlled trials evaluating apremilast in 1426 patients with moderate to severe plague psoriasis (ESTEEM 1 and 2) demonstrated that the commonest adverse reactions (AE’s) leading to discontinuation were nausea (1.6%), diarrhoea (1.0%), and headaches (0.8%). The overall proportion of subjects discontinuing due to adverse reactions was 6.1%. At week 16 these trials demonstrated significant more apremilast-treated patients (33.1%) achieved the primary end point PASI-75 than placebo (5.3%). We began prescribing apremilast in July 2015. Aim: To evaluate efficacy and tolerability of apremilast in an Irish teaching hospital psoriasis population. Methods: A proforma documenting clinical evaluation parameters, prior treatment experience and AE’s; was completed prospectively on all patients commenced on apremilast since July 2015 – July 2017. Data was collected at week 0,6,12,24,36 and week 52 with 20/71 patients having passed week 52. Efficacy was assessed using Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI). AE’s documented included GI effects, infections, changes in weight and mood. Retrospective chart review and telephone review was utilised for missing data. Results: A total of 71 adult subjects (38 male, 33 female; age range 23-57), with moderate to severe psoriasis, were evaluated. Prior treatment: 37/71 (52%) were systemic/biologic/phototherapy naïve; 14/71 (20%) has prior phototherapy alone;20/71 (28%) had previous systemic/biologic exposure; 12/71 (17%) had both psoriasis and psoriatic arthritis. PASI responses: mean baseline PASI was 10.1 and DLQI was 15.Week 6: N=71, n=15 (21%) achieved PASI 75. Week 12: N= 48, n=6 (13%) achieved a PASI 100%; n=16 (34.5%) achieved a PASI 75. Week 24: N=40, n=10 (25%) achieved a PASI 100; n=15 (37.5%) achieved a PASI 75. Week 52: N= 20, n=4 (20%) achieved a PASI 100; n= 16 (80%) achieved a PASI 75. (N= number of pts having passed the time point indicated, n= number of pts (out of N) achieving PASI or DLQI responses at that time). DLQI responses: week 24: N= 40, n=30 (75%) achieved a DLQI score of 0; n=5 (12.5%) achieved a DLQI score of 1; n=1 (2.5%) achieved a DLQI score of 10 (due to lack of efficacy). Adverse Events: The proportion of patients that discontinued treatment due to AE’s was n=7 (9.8%). One patient experienced nausea alleviated by dose reduction; another developed significant dysgeusia for certain foods, both continued therapy. Two patients lost 2-3 kg. Conclusion: Initial Irish patient experience of Apremilast appears comparable to that observed in trials with good efficacy and tolerability.

Keywords: Apremilast, introduction, Ireland, clinical audit

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Authors: Kehabtimer Shiferaw Kotiso, Getachew Hailemariam, Abiy Seifu Estifanos

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Introduction: Despite the highest share of low birth weight (LBW) for neonatal mortality and morbidity, predicting births with LBW for better intervention preparation is challenging. This study aims to predict LBW using a dataset encompassing 53,637 birth cohorts collected from 36 primary hospitals across seven regions in Ethiopia from February 2022 to June 2024. Methods: We identified ten explanatory variables related to maternal and neonatal characteristics, including maternal education, age, residence, history of miscarriage or abortion, history of preterm birth, type of pregnancy, number of livebirths, number of stillbirths, antenatal care frequency, and sex of the fetus to predict LBW. Using WEKA 3.8.2, we developed and compared seven machine learning algorithms. Data preprocessing included handling missing values, outlier detection, and ensuring data integrity in birth weight records. Model performance was evaluated through metrics such as accuracy, precision, recall, F1-score, and area under the Receiver Operating Characteristic curve (ROC AUC) using 10-fold cross-validation. Results: The results demonstrated that the decision tree, J48, logistic regression, and gradient boosted trees model achieved the highest accuracy (94.5% to 94.6%) with a precision of 93.1% to 93.3%, F1-score of 92.7% to 93.1%, and ROC AUC of 71.8% to 76.6%. Conclusion: This study demonstrates the effectiveness of machine learning models in predicting LBW. The high accuracy and recall rates achieved indicate that these models can serve as valuable tools for healthcare policymakers and providers in identifying at-risk newborns and implementing timely interventions to achieve the sustainable developmental goal (SDG) related to neonatal mortality.

Keywords: low birth weight, machine learning, classification, neonatal mortality, Ethiopia

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Authors: Alexandru-Ion Marinescu

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There exist a plethora of methods in the scientific literature which tackle the well-established task of credit score evaluation. In its most abstract form, a credit scoring algorithm takes as input several credit applicant properties, such as age, marital status, employment status, loan duration, etc. and must output a binary response variable (i.e. “GOOD” or “BAD”) stating whether the client is susceptible to payment return delays. Data imbalance is a common occurrence among financial institution databases, with the majority being classified as “GOOD” clients (clients that respect the loan return calendar) alongside a small percentage of “BAD” clients. But it is the “BAD” clients we are interested in since accurately predicting their behavior is crucial in preventing unwanted loss for loan providers. We add to this whole context the constraint that the algorithm must yield an actual, tractable mathematical formula, which is friendlier towards financial analysts. To this end, we have turned to genetic algorithms and genetic programming, aiming to evolve actual mathematical expressions using specially tailored mutation and crossover operators. As far as data representation is concerned, we employ a very flexible mechanism – LINQ expression trees, readily available in the C# programming language, enabling us to construct executable pieces of code at runtime. As the title implies, they model trees, with intermediate nodes being operators (addition, subtraction, multiplication, division) or mathematical functions (sin, cos, abs, round, etc.) and leaf nodes storing either constants or variables. There is a one-to-one correspondence between the client properties and the formula variables. The mutation and crossover operators work on a flattened version of the tree, obtained via a pre-order traversal. A consequence of our chosen technique is that we can identify and discard client properties which do not take part in the final score evaluation, effectively acting as a dimensionality reduction scheme. We compare ourselves with state of the art approaches, such as support vector machines, Bayesian networks, and extreme learning machines, to name a few. The data sets we benchmark against amount to a total of 8, of which we mention the well-known Australian credit and German credit data sets, and the performance indicators are the following: percentage correctly classified, area under curve, partial Gini index, H-measure, Brier score and Kolmogorov-Smirnov statistic, respectively. Finally, we obtain encouraging results, which, although placing us in the lower half of the hierarchy, drive us to further refine the algorithm.

Keywords: expression trees, financial credit scoring, genetic algorithm, genetic programming, symbolic evolution

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Authors: Kim Ji-Hyun, Jeon Hye-Seon, Kwon Oh-Yun, Park Eun-Young, Hwang Ui-Jae, Gwak Gyeong-Tae, Yoon Hyeo-Bin

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Stress urinary incontinence (SUI), a common women health problem, is an involuntary leakage of urine while sneezing, coughing, or physical exertion caused by insufficient strength of the pelvic floor and sphincter muscles. SUI also leads to decrease in quality of life and limits sexual activities. SUI is related to the increased bladder neck angle, bladder neck movement, funneling index, urethral width, and decreased urethral length. Various pelvic floor muscle electrical stimulation (ES) interventions have been applied to improve the symptoms of the people with SUI. ES activates afferent fibers of pudendal nerve and smoothly induces contractions of the pelvic floor muscles such as striated periurethral muscles and striated pelvic floor muscles. ES via intravaginal electrodes are the most frequently used types of the pelvic floor muscle ES for the female SUI. However, inserted electrode is uncomfortable and it increases the risks of infection. The purpose of this preliminary study was to determine if the 8-week transcutaneous pelvic floor ES would be effective to improve the symptoms and satisfaction of the females with SUI. Easy-K, specially designed ES equipment for the people with SUI, was used in this study. The oval shape stimulator can be placed on a toilet seat, and the surface has invaded electrode fit to contact with the entire vulva area while users are sitting on the stimulator. Five women with SUI were included in this experiment. Prior to the participation, subjects were instructed about procedures and precautions in using the ES. They have used the stimulator once a day for 20 minutes for each session at home. Outcome data was collected 3 times at the baseline, 4 weeks and 8 weeks after the intervention. Intravaginal sonography was used to measure the bladder neck angle, bladder neck movement, funneling index, thickness of an anterior rhabdosphincter and a posterior rhabdosphincter, urethral length, and urethral width. Leavator ani muscle (LAM) contraction strength was assessed by manual palpation according to the oxford scoring system. In addition, incontinence quality of life (IQOL) and female sexual function index (FSFI) questionnaires were used to obtain addition subjective information. Friedman test, a nonparametric statistical test, was used to determine the effectiveness of the ES. The Wilcoxon test was used for the post-hoc analysis and the significance level was set at .05. The bladder neck angle, funneling index and urethral width were significantly decreased after 8-weeks of intervention (p<.05). LAM contraction score, urethral length and anterior and posterior rhabdosphicter thickness were statistically increased by the intervention (p<.05). However, no significant change was found in the bladder neck movement. Although total score of the IQOL did not improve, the score of the ‘avoidance’ subscale of IQOL had significant improved (p<.05). FSFI had statistical difference in FSFI total score and ‘desire’ subscale (p<.05). In conclusion, 8-week use of a transcutaneous ES on peri-vulva area improved dynamic mechanical structures of the pelvic floor musculature as well as IQOL and conjugal relationship.

Keywords: electrical stimulation, Pelvic floor muscle, sonography, stress urinary incontinence, women health

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Authors: Diane Ghanem, Oscar Covarrubias, Michael Raad, Dawn LaPorte, Babar Shafiq

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Introduction: Standardized exams have long been considered a cornerstone in measuring cognitive competency and academic achievement. Their fixed nature and predetermined scoring methods offer a consistent yardstick for gauging intellectual acumen across diverse demographics. Consequently, the performance of artificial intelligence (AI) in this context presents a rich, yet unexplored terrain for quantifying AI's understanding of complex cognitive tasks and simulating human-like problem-solving skills. Publicly available AI language models such as ChatGPT have demonstrated utility in text generation and even problem-solving when provided with clear instructions. Amidst this transformative shift, the aim of this study is to assess ChatGPT’s performance on the orthopaedic surgery in-training examination (OITE). Methods: All 213 OITE 2021 web-based questions were retrieved from the AAOS-ResStudy website. Two independent reviewers copied and pasted the questions and response options into ChatGPT Plus (version 4.0) and recorded the generated answers. All media-containing questions were flagged and carefully examined. Twelve OITE media-containing questions that relied purely on images (clinical pictures, radiographs, MRIs, CT scans) and could not be rationalized from the clinical presentation were excluded. Cohen’s Kappa coefficient was used to examine the agreement of ChatGPT-generated responses between reviewers. Descriptive statistics were used to summarize the performance (% correct) of ChatGPT Plus. The 2021 norm table was used to compare ChatGPT Plus’ performance on the OITE to national orthopaedic surgery residents in that same year. Results: A total of 201 were evaluated by ChatGPT Plus. Excellent agreement was observed between raters for the 201 ChatGPT-generated responses, with a Cohen’s Kappa coefficient of 0.947. 45.8% (92/201) were media-containing questions. ChatGPT had an average overall score of 61.2% (123/201). Its score was 64.2% (70/109) on non-media questions. When compared to the performance of all national orthopaedic surgery residents in 2021, ChatGPT Plus performed at the level of an average PGY3. Discussion: ChatGPT Plus is able to pass the OITE with a satisfactory overall score of 61.2%, ranking at the level of third-year orthopaedic surgery residents. More importantly, it provided logical reasoning and justifications that may help residents grasp evidence-based information and improve their understanding of OITE cases and general orthopaedic principles. With further improvements, AI language models, such as ChatGPT, may become valuable interactive learning tools in resident education, although further studies are still needed to examine their efficacy and impact on long-term learning and OITE/ABOS performance.

Keywords: artificial intelligence, ChatGPT, orthopaedic in-training examination, OITE, orthopedic surgery, standardized testing

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Authors: Farman Ali, Asif Mahmood

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The utilization of genetic markers in prostate cancer management represents a significant advance in personalized medicine, offering the potential for more precise diagnosis and tailored treatment strategies. This paper explores the pivotal role of genetic markers in the diagnosis and treatment of prostate cancer, emphasizing their contribution to the identification of individual risk profiles, tumor aggressiveness, and response to therapy. By integrating current research findings, we discuss the application of genetic markers in developing targeted therapies and the implications for patient outcomes. Despite the promising advancements, challenges such as accessibility, cost, and the need for further validation in diverse populations remain. The paper concludes with an outlook on future directions, underscoring the importance of genetic markers in revolutionizing prostate cancer care.

Keywords: prostate cancer, genetic markers, personalized medicine, BRCA1 and BRCA2

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Authors: Archil Undilashvili, Ketevan Stvilia, Dustin Gilbreath, Giorgi Dzneladze, Gordon Charchward

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Introduction: In recent years, diverse types of wheelchairs, both local production and imported, have been made available on the Georgian market for wheelchair users. Some types of wheelchairs are sold together with a service package, while the others, including the State Program, Supported locally-produced ones, don’t provide adjustment and maintenance service packages to users. Within the USAID Physical Rehabilitation Project in Georgia, a study was conducted to assess the impact of the wheelchair service provision in line with the WHO guidelines on the health and overall satisfaction of wheelchair users in Georgia. Methodology: A cross-sectional survey was conducted in May 2021. A structured questionnaire was used for telephone interviews that, along with socio-demographic characteristics, included questions for assessment of accessibility, availability, timeliness, cost and quality of wheelchair services received. Out of 1060 individuals listed in the census of wheelchair users, 752 were available for interview, with an actual response rate of 73.4%. 552 wheelchair users (31%) or their caregivers (69%) agreed to participate in the survey. In addition to using descriptive statistics, the study used multivariate matching of wheelchair users who received wheelchair services and who did not (control group). In addition, to evaluate satisfaction with service provision, respondents were asked to assess services. Findings: The majority (67%) of wheelchair users included in the survey were male. The average age of participants was 43. The three most frequently named reasons for using a wheelchair were cerebral palsy (29%), followed by stroke (18%), and amputation (12%). Users have had their current chair for four years on average. Overall, 60% of respondents reported that they were assessed before providing a wheelchair, but only half of them reported that their preferences and needs were considered. Only 13% of respondents had services in line with WHO guidelines and only 22% of wheelchair users had training when they received their current chair. 16% of participants said they had follow-up services, and 41% received adjustment services after receiving the chair. A slight majority (56%) of participants were satisfied with the quality of service provision and the service provision overall. Similarly, 55% were satisfied with the accessibility of service provision. A slightly larger majority (61%) were satisfied with the timeliness of service provision. The matching analysis suggests that users that received services in line with WHO guidelines were more satisfied with their chairs (the difference 17 point/0-100 scale) and they were four percentage points less likely to have health problems attributed to the chair. The regression analysis provides a similar finding of a 21 point increase in satisfaction attributable to services. Conclusion: The provision of wheelchair services in line with WHO guidelines and with follow-up services is likely to have a positive impact on the daily lives of wheelchair users in Georgia. Wheelchair services should be institutionalized as a standard component of wheelchair provision in Georgia.

Keywords: physical rehabilitation, wheelchair users, persons with disabilities, wheelchair production

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Authors: Headman Hebe, Arnold Taringa

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Background of the study: The benefits derived from Environmental and Sustainability Education (ESE) go beyond obtaining knowledge about the environment and the impact of human beings on the environment. Hence, it is sensible to expose learners to various resources that could enable meaningful environment-inclined pedagogy. The schoolgrounds, where they are utilised to promote ESE, benefit holistic learner development. However, empirical evidence, globally, suggests that young children’s contact with nature is declining due to urbanization, safety concerns by parents/guardians, and greater dependency on technology. Modern children spend much time on videogames and social media with very little time in the natural environment. Furthermore, national education departments in numerous countries have made tangible efforts to embed environmental and place-based learning to their school curricula. South Africa is one of those countries whose national school education curriculum advocates for ESE in pedagogy. Nevertheless, there is paucity of research conducted in South Africa on schoolgrounds as potential enablers of ESE and tools to foster a connection between youngsters and the natural environment. Accordingly, this study was essential as it seeks to determine the extent to which environmental learning is accommodated in pedagogy. Significantly, it investigates efforts made to use schoolgrounds for pedagogical purposes to connect children with the natural environment. Therefore, this study was conducted to investigate the accessibility and use of schoolgrounds for environment-inclined pedagogy in Natural and Social Sciences in two schools located in the Mpumalanga Province of South Africa. It tries to answer the question: To what extent are schoolgrounds used to promote environmental and sustainability education in the selected schools?The sub-questions: How do teachers and learners perceive the use of schoolgrounds for environmental and sustainability education activities? How does the organization of schoolgrounds offer opportunities for environmental education activities and accessibility for learners? Research method: This qualitative–interpretive case study used purposive and convenient sampling for participant selection. Forty-six respondents: 40 learners (twenty grade 7 learners per school), 2 school principals and 4 grade 7 participated in this study. Data collection tools were observations, interviews, audio-visual recordings and questionnaires while data analysis was done thematically. Major findings: The findings of the study point to: The lack of teacher training and infrastructure in the schoolgrounds and, no administrative support. Unclear curriculum guidelines on the use of schoolgrounds for ESE. The availability various elements in the schoolgrounds that could aid ESE activities. Learners denied access to certain parts of the schoolgrounds. Lack of time and curriculum demands constrain teachers from using schoolgrounds.

Keywords: affordances, environment and sustainability education, experiential learning, schoolgrounds

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Authors: Dhanya Nair, Nicholas Mirchandani

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Musical haptic systems can enhance a listener’s musical experience while providing an alternative platform for the hearing impaired to experience music. Current music tactile technologies focus on representing tactile metronomes to synchronize performers or encoding musical notes into distinguishable (albeit distracting) tactile patterns. There is growing interest in the development of musical haptic systems to augment the auditory experience, although the haptic-music relationship is still not well understood. This paper represents a tactile music interface that provides vibrations to multiple fingertips in synchronicity with auditory music. Like an audio equalizer, different frequency bands are filtered out, and the power in each frequency band is computed and converted to a corresponding vibrational strength. These vibrations are felt on different fingertips, each corresponding to a different frequency band. Songs with music from different spectrums, as classified by their energy and valence, were used to test the effectiveness of the system and to understand the relationship between music and tactile sensations. Three participants were trained on one song categorized as sad (low energy and low valence score) and one song categorized as happy (high energy and high valence score). They were trained both with and without auditory feedback (listening to the song while experiencing the tactile music on their fingertips and then experiencing the vibrations alone without the music). The participants were then tested on three songs from both categories, without any auditory feedback, and were asked to classify the tactile vibrations they felt into either category. The participants were blinded to the songs being tested and were not provided any feedback on the accuracy of their classification. These participants were able to classify the music with 100% accuracy. Although the songs tested were on two opposite spectrums (sad/happy), the preliminary results show the potential of utilizing a vibrotactile equalizer, like the one presented, for augmenting musical experience while furthering the current understanding of music tactile relationship.

Keywords: haptic music relationship, tactile equalizer, tactile music, vibrations and mood

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Authors: Arezoo Fallahi

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Background and purpose: Non-alcoholic fatty liver is one of the most common liver disorders, which, as the most important cause of death from liver disease, has unpleasant consequences and complications. The aim of this study was to investigate the effect of an educational intervention based on a health belief model to prevent non-alcoholic fatty liver among women. Materials and Methods: This experimental study was performed among 110 women referring to comprehensive health service centers in Malayer City, west of Iran, in 2023. Using the available sampling method, 110 Participants were divided into experimental and control groups. The data collection tool included demographic characteristics and a questionnaire based on the health belief model. In The experimental group, three one-hour training sessions were conducted in the form of pamphlets, lectures and group discussions. Data were analyzed using SPSS software version 21, by correlation tests, paired t-tests independent t-tests. Results: The mean age of participants was 38.07±6.28 years, and Most of the participants were middle-aged, married, housewives with academic education, middle-income and overweight. After the educational intervention, the mean scores of the constructs include perceived sensitivity (p=0.01), perceived severity (p=0.01), perceived benefits (p=0.01), guidance for internal (p=0.01) and external action (p=0.01), and perceived self-efficacy (p=0.01) in the experimental group were significantly higher than the control group. The score of perceived barriers in the experimental group decreased after training. The perceived obstacles score in the test group decreased after the training (15.2 ± 3.9 v.s 11.2 ± 3.3, (p<0.01). Conclusion: The findings of the study showed that the design and implementation of educational programs based on the constructs of the health belief model can be effective in preventing women from developing higher levels of non-alcoholic fatty liver.

Keywords: health, education, believe, behaviour

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