Search results for: rigorous literature review

Authors: Andleeb Zahra, Itrat Rubab, Sumaira Malik, Amina Khan, Muhammad Jawad Khan, M. Qaiser Fatmi

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Oral squamous cell carcinoma (OSCC) is one of the most common cancers worldwide. Recent studies have highlighted the role of miRNA in disease pathology, indicating its potential use in an early diagnostic tool. miRNAs are small, double stranded, non-coding RNAs that regulate gene expression by deregulating mRNAs. miRNAs play important roles in modifying various cellular processes such as cell growth, differentiation, apoptosis, and immune response. Dis-regulated expression of miRNAs is known to affect the cell growth, and this may function as tumor suppressors or oncogenes in various cancers. Objectives: The main objectives of this study were to characterize the extracellular miRNAs involved in oral cancer (OC) to assist early detection of cancer as well as to propose a list of genes that can potentially be used as biomarkers of OC. We used gene expression data by microarrays already available in literature. Materials and Methods: In the first step, a total of 318 miRNAs involved in oral carcinoma were shortlisted followed by the prediction of their target genes. Simultaneously, the differentially expressed genes (DEGs) of oral carcinoma from all experiments were identified. The common genes between lists of DEGs of OC based on experimentally proven data and target genes of each miRNA were identified. These common genes are the targets of specific miRNA, which is involved in OC. Finally, a list of genes was generated which may be used as biomarker of OC. Results and Conclusion: In results, we included some of pathways in cancer to show the change in gene expression under the control of specific miRNA. Ingenuity pathway analysis (IPA) provided a list of major biomarkers like CDH2, CDK7 and functional enrichment analysis identified the role of miRNA in major pathways like cell adhesion molecules pathway affected by cancer. We observed that at least 25 genes are regulated by maximum number of miRNAs, and thereby, they can be used as biomarkers of OC. To better understand the role of miRNA with respect to their target genes further experiments are required, and our study provides a platform to better understand the miRNA-OC relationship at genomics level.

Keywords: biomarkers, gene expression, miRNA, oral carcinoma

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Authors: Chi-Feng Lai, Wen-Chun Liao Liao

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Many people are bothered by sleep difficulties in Taiwan’s society. However, majority of patients get medical treatments without a comprehensive sleep assessment. It is still a big challenge to formulate a comprehensive assessment of sleep difficulties in clinical settings, even though many assessment tools have existed in literature. This study tries to implement reliable and effective ‘comprehensive sleep assessment scales’ in a medical center and to explore differences in sleep-related factors between clinic clients with or without sleep difficulty complaints. The comprehensive sleep assessment (CSA) scales were composed of 5 dimensions: ‘personal factors’, ‘physiological factors’, ‘psychological factors’, ‘social factors’ and ‘environmental factors, and were first evaluated by expert validity and 20 participants with test-retest reliability. The Content Validity Index (CVI) of the CSA was 0.94 and the alpha of the consistency reliability ranged 0.996-1.000. Clients who visited sleep clinic due to sleep difficulties (n=32, 16 males and 16 females, ages 43.66 ±14.214) and gender-and age- matched healthy subjects without sleep difficulties (n=96, 47 males and 49 females, ages 41.99 ±13.69) were randomly recruited at a ratio of 1:3 (with sleep difficulties vs. without sleep difficulties) to compare their sleep and the CSA factors. Results show that all clinic clients with sleep difficulties did have poor sleep quality (PSQI>5) and mild to moderate daytime sleepiness (ESS >11). Personal factors of long working hours (χ2= 10.315, p=0.001), shift workers (χ2= 8.964, p=0.003), night shift (χ2=9.395, p=0.004) and perceived stress (χ2=9.503, p=0.002) were disruptors of sleep difficulties. Physiological factors from physical examination including breathing by mouth, low soft palate, high narrow palate, Edward Angle, tongue hypertrophy, and occlusion of the worn surface were observed in clinic clients. Psychological factors including higher perceived stress (χ2=32.542, p=0.000), anxiety and depression (χ2=32.868, p=0.000); social factors including lack of leisure activities (χ2=39.857, p=0.000), more drinking habits (χ2=1.798, p=0.018), irregular amount and frequency in meals (χ2=5.086, p=0.024), excessive dinner (χ2=21.511, p=0.000), being incapable of getting up on time due to previous poor night sleep (χ2=4.444, p=0.035); and environmental factors including lights (χ2=7.683, p=0.006), noise (χ2=5.086, p=0.024), low or high bedroom temperature (χ2=4.595, p=0.032) were existed in clients. In conclusion, the CSA scales can work as valid and reliable instruments for evaluating sleep-related factors. Findings of this study provide important reference for assessing clinic clients with sleep difficulties.

Keywords: comprehensive sleep assessment, sleep-related factors, sleep difficulties

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Authors: Mariangela Viviani, Daniele Germano, Simone Colace, Agostino Forestiero, Giuseppe Papuzzo, Sara Laurita

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Nowadays, people spend most of their time in closed environments, in offices, or at home. Therefore, secure and highly livable environmental conditions are needed to reduce the probability of aerial viruses spreading. Also, to lower the human impact on the planet, it is important to reduce energy consumption. Heating, Ventilation, and Air Conditioning (HVAC) systems account for the major part of energy consumption in buildings [1]. Devising systems to control and regulate the airflow is, therefore, essential for energy efficiency. Moreover, an optimal setting for thermal comfort and air quality is essential for people’s well-being, at home or in offices, and increases productivity. Thanks to the features of Artificial Intelligence (AI) tools and techniques, it is possible to design innovative systems with: (i) Improved monitoring and prediction accuracy; (ii) Enhanced decision-making and mitigation strategies; (iii) Real-time air quality information; (iv) Increased efficiency in data analysis and processing; (v) Advanced early warning systems for air pollution events; (vi) Automated and cost-effective m onitoring network; and (vii) A better understanding of air quality patterns and trends. We propose AIR SAFE, an IoT-based infrastructure designed to optimize air quality and thermal comfort in indoor environments leveraging AI tools. AIR SAFE employs a network of smart sensors collecting indoor and outdoor data to be analyzed in order to take any corrective measures to ensure the occupants’ wellness. The data are analyzed through AI algorithms able to predict the future levels of temperature, relative humidity, and CO₂ concentration [2]. Based on these predictions, AIR SAFE takes actions, such as opening/closing the window or the air conditioner, to guarantee a high level of thermal comfort and air quality in the environment. In this contribution, we present the results from the AI algorithm we have implemented on the first s et o f d ata c ollected i n a real environment. The results were compared with other models from the literature to validate our approach.

Keywords: air quality, internet of things, artificial intelligence, smart home

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Authors: Emigdio Mendoza, Patricia Fernandez, Cristian Gomez

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Magnesium alloys have generated great interest for several industrial applications because their high specific strength and low density make them a very attractive alternative for the manufacture of various components; however, these alloys present a limitation with their hexagonal crystal structure that limits the deformation mechanisms at room temperature likewise the molding components alternatives, it is for this reason that severe plastic deformation processes have taken a huge relevance recently because these, allow high deformation rates to be applied that induce microstructural changes where the deficiency in the sliding systems is compensated with crystallographic grains reorientations or crystal twinning. The present study reports a statistical analysis of process temperature, number of passes and shear angle with respect to the shear stress in severe plastic deformation process denominated 'Equal Channel Angular Sheet Drawing (ECASD)' applied to the magnesium alloy AZ31B through Python Statsmodels libraries, additionally a Post-Hoc range test is performed using the Tukey statistical test. Statistical results show that each variable has a p-value lower than 0.05, which allows comparing the average values of shear stresses obtained, which are in the range of 7.37 MPa to 12.23 MPa, lower values in comparison to others severe plastic deformation processes reported in the literature, considering a value of 157.53 MPa as the average creep stress for AZ31B alloy. However, a higher stress level is required when the sheets are processed using a shear angle of 150°, due to a higher level of adjustment applied for the shear die of 150°. Temperature and shear passes are important variables as well, but there is no significant impact on the level of stress applied during the ECASD process. In the processing of AZ31B magnesium alloy sheets, ECASD technique is evidenced as a viable alternative in the modification of the elasto-plastic properties of this alloy, promoting the weakening of the basal texture, which means, a better response to deformation, whereby, during the manufacture of parts by drawing or stamping processes the formation of cracks on the surface can be reduced, presenting an adequate mechanical performance.

Keywords: plastic deformation, strain, sheet drawing, magnesium

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Authors: Rammah Abdlbagi, Egmen Tazcan, Kiriti Tripathi, Vinayagam Sudhakar, Thomas Swallow, Aakash Pai

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Introduction and Objectives: MRI has an increasing role in the diagnosis and staging of prostate cancer. Multiparametric MRI includes multiple sequences, including T2 weighting, diffusion weighting, and dynamic contrast enhancement (DCE). Administration of DCE is expensive, time-consuming, and requires medical supervision due to the risk of anaphylaxis. Biparametric MRI (bpMRI), without DCE, overcomes many of these issues; however, there is conflicting data on its accuracy. Furthermore, data on the concordance between bpMRI lesion and pathology specimen, as well as the rates of cancer stage upgrading after surgery, is limited within the available literature. This study aims to examine the diagnostic test accuracy of bpMRI in the diagnosis of prostate cancer and radiological assessment of prostate cancer staging. Specifically, we aimed to evaluate the ability of bpMRI to accurately localise malignant lesions to better understand its accuracy and application in MRI-targeted biopsies. Materials and Methods: One hundred and forty patients who underwent bpMRI prior to radical prostatectomy (RP) were retrospectively reviewed from a single institution. Histological grade from the prostate biopsy was compared with surgical specimens from RP. Clinically significant prostate cancer (csPCa) was defined as Gleason grade group ≥2. bpMRI staging was compared with RP histology. Results: Overall sensitivity of bpMRI in diagnosing csPCa independent of location and staging was 98.87%. Of the 140 patients, 29 (20.71%) had their prostate biopsy histology upgraded at RP. 61 (43.57%) patients had csPca noted on RP specimens in areas that were not identified on the bpMRI. 55 (39.29%) had upstaging after RP from the original staging with bpMRI. Conclusions: Whilst the overall sensitivity of bpMRI in predicting any clinically significant cancer was good, there was notably poor concordance in the location of the tumour between bpMRI and eventual RP specimen. The results suggest that caution should be exercised when using bpMRI for targeted prostate biopsies and validates the continued role of systemic biopsies. Furthermore, a significant number of patients were upstaged at RP from their original staging with bpMRI. Based on these findings, bpMRI results should be interpreted with caution and can underestimate TNM stage, requiring careful consideration of treatment strategy.

Keywords: biparametric MRI, Ca prostate, staging, post prostatectomy histology

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Authors: Shamsulhaq Amin

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Unbound granular materials (UGMs) are pivotal in ensuring long-term quality, especially in the layers under the surface of flexible pavements and other constructions. This study seeks to better understand the behavior of the UGMs by looking at popular models for predicting lasting deformation under various levels of stresses and load cycles. These models focus on variables such as the number of load cycles, stress levels, and features specific to materials and were evaluated on the basis of their ability to accurately predict outcomes. The study showed that these factors play a crucial role in how well the models work. Therefore, the research highlights the need to look at a wide range of stress situations to more accurately predict how much the UGMs bend or shift. The research looked at important factors, like how permanent deformation relates to the number of times a load is applied, how quickly this phenomenon happens, and the shakedown effect, in two different types of UGMs: granite and limestone. A detailed study was done over 100,000 load cycles, which provided deep insights into how these materials behave. In this study, a number of factors, such as the level of stress applied, the number of load cycles, the density of the material, and the moisture present were seen as the main factors affecting permanent deformation. It is vital to fully understand these elements for better designing pavements that last long and handle wear and tear. A series of laboratory tests were performed to evaluate the mechanical properties of materials and acquire model parameters. The testing included gradation tests, CBR tests, and Repeated load triaxial tests. The repeated load triaxial tests were crucial for studying the significant components that affect deformation. This test involved applying various stress levels to estimate model parameters. In addition, certain model parameters were established by regression analysis, and optimization was conducted to improve outcomes. Afterward, the material parameters that were acquired were used to construct graphs for each model. The graphs were subsequently compared to the outcomes obtained from the repeated load triaxial testing. Additionally, the models were evaluated to determine if they demonstrated the two inherent deformation behaviors of materials when subjected to repetitive load: the initial phase, post-compaction, and the second phase volumetric changes. In this study, using log-log graphs was key to making the complex data easier to understand. This method made the analysis clearer and helped make the findings easier to interpret, adding both precision and depth to the research. This research provides important insight into picking the right models for predicting how these materials will act under expected stress and load conditions. Moreover, it offers crucial information regarding the effect of load cycle and permanent deformation as well as the shakedown effect on granite and limestone UGMs.

Keywords: permanent deformation, unbound granular materials, load cycles, stress level

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Authors: Karolína Augustovaá

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Turkey’s eastern borders have been at the center of criticism by the European Commission who condemns restrictions against Kurdish civilians as the result of Turkey’s military operations against terrorist organizations (namely PKK). Yet, the Commission has launched economic and political support for numerous military projects along the Iran-Turkey border to fight cross-border crime (namely “illegal” migration) along its external borders. Whilst border externalization has been extensively examined in the EU’s wide neighborhood, its analysis from the ground in conflict zones is emerging. The existing analysis also rarely considers the impact of external border management beyond international migration - on the local context and its people. However, tough externalization policies at borders, where local wars are fought, are fundamental to scrutinize as they invite us to question the effects of EU’s migration management on diverse communities navigating their life along external borders. To fill this research lacunae, this article examines intersections between the local military operations and international (EU-Turkey) migration management at the Turkey’s border with Iran and questions their impact on the everyday struggles of people living at and migrating across the border. To do so, it applies critical feminist and military literature to border studies. Methodologically, the article draws upon ethnographic research in Van (Eastern Turkey), using participant observations and interviews with sixty participants. This article argues that the EU’s externalization policies add to the violence generated by the local militarized conflict and eventually (re-)produce it in the forms of push-backs and physical violence against people who daily cross the border irregularly for their physical/economic survival. By doing so, I suggest that (inter)national fears of terrorism and migration inter-sect, materialize and affect everyday sites of diverse racialized groups living at and moving across external borders, such as international migrants (Afghans) and the local residents (Kurds) at the Turkey-Iran border. This article highlights the need to analyze the local border context in tandem with international migration management in the EU’s wider neighborhood to understand how conflict and violence evolves there.

Keywords: european union border externalization, eastern turkey, migration, conflict, kurdish question

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Authors: Shadi Fathi, Moura Mehravar, Mujib Rahman

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Over the years,increased demands on railways, the emergence of high-speed trains and heavy axle loads, ageing, and deterioration of the existing tracks, is imposing costly maintenance actions on the railway sector. The need for developing a fast andcost-efficient non-destructive assessment method for the structural evaluation of railway tracksis therefore critically important. The layer modulus is the main parameter used in the structural design and evaluation of the railway track substructure (foundation). Among many recently developed NDTs, Falling Weight Deflectometer (FWD) test, widely used in pavement evaluation, has shown promising results for railway track substructure monitoring. The surface deflection data collected by FWD are used to estimate the modulus of substructure layers through the back-analysis technique. Although there are different commerciallyavailableback-analysis programs are used for pavement applications, there are onlya limited number of research-based techniques have been so far developed for railway track evaluation. In this paper, the suitability, accuracy, and reliability of the BAKFAAsoftware are investigated. The main rationale for selecting BAKFAA as it has a relatively straightforward user interfacethat is freely available and widely used in highway and airport pavement evaluation. As part of the study, a finite element (FE) model of a railway track section near Leominsterstation, Herefordshire, UK subjected to the FWD test, was developed and validated against available field data. Then, a virtual experimental database (including 218 sets of FWD testing data) was generated using theFE model and employed as the measured database for the BAKFAA software. This database was generated considering various layers’ moduli for each layer of track substructure over a predefined range. The BAKFAA predictions were compared against the cone penetration test (CPT) data (available from literature; conducted near to Leominster station same section as the FWD was performed). The results reveal that BAKFAA overestimatesthe layers’ moduli of each substructure layer. To adjust the BAKFA with the CPT data, this study introduces a correlation model to make the BAKFAA applicable in railway applications.

Keywords: back-analysis, bakfaa, railway track substructure, falling weight deflectometer (FWD), cone penetration test (CPT)

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Authors: Adi Levy

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Military and security personnel defections during nonviolent resistance (NVR) campaigns are recognized as an effective way of undermining the regime’s power, but they also may generate moral dilemmas that contradict the moral standing of NVR tactics. NVR campaigns have been primarily praised for their adherence to moral and legal norms, yet some of NVR tactics raise serious ethical concerns. This paper focuses on NVR tactics that seek to promote defections and disobedience within military and security personnel to sustain their campaign. Academic literature regarding NVR tactics indicates that compared to violent forms of resistance, defections are more likely to occur when security forces confront nonviolent activists. Indeed, defections play a strategically fundamental role in nonviolent campaigns, particularly against authoritarian regimes, as it enables activists to undermine the regime’s central pillars of support. This study examines the events of the Arab Spring and discusses the ethical problems that arise in nonviolent activists’ promotion of defections and disobedience. The cases of Syria and Egypt suggest that the strategic promotion of defections and disobedience was significantly effective in sustaining the campaign. Yet, while such defections enhance nonviolent activists’ resilience, how they are promoted can be morally contentious and the consequences can be dire. Defections are encouraged by social, moral and emotional appeals that use the power disparities between unarmed civilians and powerful regimes to affect soldiers and security personnel’s process of decision-making. In what is commonly referred to as dilemma action, nonviolent activists deliberately entangle security forces in a moral dilemma that compels them to follow a moral code to protect unarmed civilians. In this way, activists sustain their struggle and even gain protection. Nonviolent activists are likely to be completely defeated when confronted with armed forces. Therefore they rely on the military and security personnel’s moral conscious of convincing them to refrain from using force against them. While this is effective, it also leaves soldiers and security forces exposed to the implications and punishments that might follow their disobedience or defection. As long as they remain nonviolent, activists enjoy civilian immunity despite using morally contentious tactics. But the severe implications brought upon defectors. As a result, demand a deep examination of this tactic’s moral permissibility and a discussion that assesses culpability for the moral implications of its application.

Keywords: culpability, defections, nonviolence, permissibility

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Authors: E. Ielegems, J. Herssens, J. Vanrie

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Designers require knowledge and data about a diversity of users throughout the design process to create inclusive design solutions which are usable, understandable and desirable by everyone. Besides understanding users’ needs and expectations, the ways in which users perceive and experience the built environment contain valuable knowledge for architects. Since users’ perceptions and experiences are mainly tacit by nature, they are much more difficult to express in words and therefore more difficult to externalise. Nevertheless, literature confirms the importance of articulating embodied knowledge from users throughout the design process. Hence, more insight is needed into the ways architects can build knowledge on Universal Design through direct user contact. In a project called ‘light up for all’ architecture students are asked to design a light switch and socket, elegant, usable and understandable to the greatest extent possible by everyone. Two workshops with user/experts are organised in the first stages of the design process in which students could gain insight into users’ experiences through direct contact. Three data collection techniques are used to analyse the teams’ design processes. First, students were asked to keep a design diary, reporting design activities, personal experiences, and thoughts about users throughout the design process. Second, one of the authors observed workshops taking field notes. Finally, focus groups are conducted with the design teams after the design process was finished. By means of analysing collected qualitative data, we first identify different design aspects that make the teams’ proposals more inclusive than standard design solutions. For this paper, we specifically focus on aspects that externalise embodied user knowledge from users’ experiences. Subsequently, we look at designers’ approaches to learn about these specific aspects throughout the design process. Results show that in some situations, designers perceive contradicting knowledge between observations and verbal conversations, which shows the value of direct user contact. Additionally, findings give indications on values and limitations of working with selected prototypes as ‘boundary objects’ when externalising users’ experiences. These insights may help researchers to better understand designers’ process of eliciting embodied user knowledge. This way, research can offer more effective support to architects, which may result in better incorporating users’ experiences so that the built environment gradually can become more inclusive for all.

Keywords: universal design, architecture, design process, embodied user knowledge

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Authors: Danar Agus Susanto, Hermawan Febriansyah, Meilinda Ayundyahrini

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The availability of spring water to meet people demand is often a problem, especially in tropical areas with very limited surface water sources, or very deep underground water. Although the technology and equipment of pumping system are available and easy to obtain, but in remote areas, the availability of pumping system is difficult, due to the unavailability of fuel or the lack of electricity. Solar Water Pumping System (SWPS) became one of the alternatives that can overcome these obstacles. In the tropical country, sunlight can be obtained throughout the year, even in remote areas. SWPS were already widely built in Indonesia, but many encounter problems during operations, such as decreased of efficiency; pump damaged, damaged of controllers or inverters, and inappropriate photovoltaic performance. In 2011, International Electrotechnical Commission (IEC) issued the IEC standard 62253:2011 titled Photovoltaic pumping systems - Design qualification and performance measurements. This standard establishes design qualifications and performance measurements related to the product of a solar water pumping system. National Standardization Agency of Indonesia (BSN) as the national standardization body in Indonesia, has not set the standard related to solar water pumping system. This research to study operational procedures of SWPS by adopting of IEC Standard 62253:2011 to be Indonesia Standard (SNI). This research used literature study and field observation for installed SWPS in Indonesia. Based on the results of research on SWPS already installed in Indonesia, IEC 62253: 2011 standard can improve efficiency and reduce operational failure of SWPS. SWPS installed in Indonesia still has GAP of 51% against parameters in IEC standard 62253: 2011. The biggest factor not being met is related to operating and maintenance handbooks for personnel that included operation and repair procedures. This may result in operator ignorance in installing, operating and maintaining the system. The Photovoltaic (PV) was also the most non-compliance factor of 71%, although there are 22 Indonesia Standard (SNI) for PV (modules, installation, testing, and construction). These research samples (installers, manufacturers/distributors, and experts) agreed on the parameter in the IEC standard 62253: 2011 able to improve the quality of SWPS in Indonesia. Recommendations of this study, that is required the adoption of IEC standard 62253:2011 into SNI to support the development of SWPS for remote areas in Indonesia.

Keywords: efficiency, inappropriate installation, remote areas, solar water pumping system, standard

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Authors: Amjad Ali Khan, Muhammad Ishaq Saqi, Kashif Ali

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The focus of hydrocarbon exploration in Pakistan has been primarily on conventional hydrocarbon resources. Directorate General Petroleum Concessions (DGPC) has taken the lead on the assessment of indigenous unconventional oil and gas resources, which has resulted in a ‘Shale Oil/Gas Resource Assessment Study’ conducted with the help of USAID. This was critically required in the energy-starved Pakistan, where the gap between indigenous oil & gas production and demand continues to widen for a long time. Exploration & exploitation of indigenous unconventional resources of Pakistan have become vital to meet our energy demand and reduction of oil and gas import bill of the country. This study has attempted to bridge a critical gap in geological information about the potential of shale gas & oil in Pakistan in the four formations, i.e., Sembar, Lower Goru, Ranikot and Ghazij in the Middle and Lower Indus Basins, which were selected for the study as for resource assessment for shale gas & oil. The primary objective of the study was to estimate and establish shale oil/gas resource assessment of the study area by carrying out extensive geological analysis of exploration, appraisal and development wells drilled in the Middle and Lower Indus Basins, along with identification of fairway(s) and sweet spots in the study area. The Study covers the Lower parts of the Middle Indus basins located in Sindh, southern Punjab & eastern parts of the Baluchistan provinces, with a total sedimentary area of 271,795 km2. Initially, 1611 wells were reviewed, including 1324 wells drilled through different shale formations. Based on the availability of required technical data, a detailed petrophysical analysis of 124 wells (21 Confidential & 103 in the public domain) has been conducted for the shale gas/oil potential of the above-referred formations. The core & cuttings samples of 32 wells and 33 geochemical reports of prospective Shale Formations were available, which were analyzed to calibrate the results of petrophysical analysis with petrographic/ laboratory analyses to increase the credibility of the Shale Gas Resource assessment. This study has identified the most prospective intervals, mainly in Sembar and Lower Goru Formations, for shale gas/oil exploration in the Middle and Lower Indus Basins of Pakistan. The study recommends seven (07) sweet spots for undertaking pilot projects, which will enable to evaluate of the actual production capability and production sustainability of shale oil/gas reservoirs of Pakistan for formulating future strategies to explore and exploit shale/oil resources of Pakistan including fiscal incentives required for developing shale oil/gas resources of Pakistan. Some E&P Companies are being persuaded to make a consortium for undertaking pilot projects that have shown their willingness to participate in the pilot project at appropriate times. The location for undertaking the pilot project has been finalized as a result of a series of technical sessions by geoscientists of the potential consortium members after the review and evaluation of available studies.

Keywords: conventional resources, petrographic analysis, petrophysical analysis, unconventional resources, shale gas & oil, sweet spots

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Authors: Mulindwa Gerald

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Forced Migration is believed to be the most pressing issue in migration studies today, it therefore makes it of paramount importance that we examine the efficacy of the prevailing laws, treaties, conventions and global policies of refugee management. It suffices to note that the existing policies are vague and ambiguous encouraging the hospitality but not assessing the social economic impact to not only the refugees but also their host communities. The commentary around the Off-shore arrangements like one of UK-Rwanda and the legal implications of the same, make it even more fascinating. These are issues that need to be amplified and captured in the Migration Policies. In Uganda, a small landlocked country in East Africa, there always appeared new faces who were refugees from the Congo and Rwanda the neighboring countries to the West and South West respectively. The refugees would migrate to Uganda with absolutely no idea whatsoever how they were going to meet the daily needs of life, no food, no shelter, no clothing. It interest’s one’s mind to conscientiously interrogate the policy issues surrounding refugee management. The 1951 convention sets a number of obligations to states and the conundrum, faced by citizens of the universe interested in Migration studies is ensuring maximum compliance to these obligations considering the resource challenges. States have a duty to protect refugees in accordance with Article 14 of the Universal Declaration for Human Rights which was adopted by the 1951 convention, these speak to rights like the most important right of refugees known as the Principle of Non-Refoulement, which prohibits expulsion or return of refugees or asylum seekers The International Organization for Migrations projection of the number of migrants globally by 2050 was overwhelmingly surpassed by 2019 due to wars, conflicts that have been experienced in different parts of the globe. This is also due natural calamities and tough economic conditions. It is a descriptive analysis that encompasses a qualitative design research based on a case study involving both desk research and field study. The use of qualitative research approaches like interview guides, document review and direct observation methods helped to bring in the experience, social, behavioral and cultural aspects of the respondents into the study, and since qualitative research uses subjective information and not limited to the rigidly definable variables, thus it helped to explore the research area of the study. it therefore verily believe that this paper is going to trigger perspectives and spark a conversation on this really pressing global issue of refugees and asylum seekers, it is suggesting viable solutions to the management challenges while making recommendations like the ensuring that no refugees or asylum seekers are closed at any borders on the globe for instance a concerted effort of all global players to ensure that refugees are protected efficiently.

Keywords: management, migration, refugees, rights

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Authors: Andrea Zielke-Nadkarni

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Pain management is a question of quality of life and an indicator for nursing quality. Chronic pain which is predominant in oncology and palliative nursing situations is perceived today as a multifactorial, individual emotional experience with specific characteristics including the sociocultural dimension when dealing with migrant patients. This dimension of chronic pain is of major importance in professional nursing of migrant patients in hospices or palliative care units. Objectives of the study are: 1. To find out more about the sociocultural views on pain and nursing care, on customs and nursing practices connected with pain of both Turkish Muslim and German Christian women, 2. To improve individual and family oriented nursing practice with view to sociocultural needs of patients in severe pain in palliative care. In a qualitative-explorative comparative study 4 groups of women, Turkish Muslims immigrants (4 from the first generation, 5 from the second generation) and German Christian women of two generations (5 of each age group) of the same age groups as the Turkish women and with similar educational backgrounds were interviewed (semistructured ethnographic interviews using Spradley, 1979) on their perceptions and experiences of pain and nursing care within their families. For both target groups the presentation will demonstrate the following results in detail: Utterance of pain as well as “private” and “public” pain vary within different societies and cultures. Permitted forms of pain utterance are learned in childhood and determine attitudes and expectations in adulthood. Language, especially when metaphors and symbols are used, plays a major role for misunderstandings. The sociocultural context of illness may include specific beliefs that are important to the patients and yet seem more than far-fetched from a biomedical perspective. Pain can be an influential factor in family relationships where respect or hierarchies do not allow the direct utterance of individual needs. Specific resources are often, although not exclusively, linked to religious convictions and are significantly helpful in reducing pain. The discussion will evaluate the results of the study with view to the relevant literature and present nursing interventions and instruments beyond medication that are helpful when dealing with patients from various socio-cultural backgrounds in painful end-oflife situations.

Keywords: pain management, migrants, sociocultural context, palliative care

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Authors: Chang Liu, Hanwen Zhang, Vikash Sharma, Don Eliseo Lucerno-Prisno III, Emmanuel Yujuico, Maulik Chokshi, Prashanthi Krishnakumar, Bach Xuan Tran, Giang Thu Vu, Kamilla Anna Pinter, Shenglan Tang

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Background and Aims: Globally, many health systems focus on hospital-based healthcare models targeting acute care and disease treatment, which are not effective in addressing the challenges of ageing populations, chronic conditions, multi-morbidities, and increasingly unhealthy lifestyles. Recently, integrated care programs on chronic diseases have been developed, piloted, and implemented to meet such challenges. However, integrated care programs in the Asia-Pacific region vary in the levels of integration from linkage to coordination to full integration. This study aims to identify and analyze existing cases of integrated care in the Asia-Pacific region and identify the facilitators and barriers in order to improve existing cases and inform future cases. Methods: The study is a comparative study, with a combination approach of desk-based research and key informant interviews. The selected countries included in this study represent a good mix of lower-middle income countries (the Philippines, India, Vietnam, and Fiji), upper-middle income country (China), and high-income country (Singapore) in the Asia-Pacific region. Existing integrated care programs were identified through the scoping review approach. Trigger, history, general design, beneficiaries, and objectors were summarized with barriers and facilitators of integrated care based on key informant interviews. Representative case(s) in each country were selected and comprehensively analyzed through deep-dive case studies. Results: A total of 87 existing integrated care programs on chronic diseases were found in all countries, with 44 in China, 21 in Singapore, 12 in India, 5 in Vietnam, 4 in the Philippines, and 1 in Fiji. 9 representative cases of integrated care were selected for in-depth description and analysis, with 2 in China, the Philippines, and Vietnam, and 1 in Singapore, India, and Fiji. Population aging and the rising chronic disease burden have been identified as key drivers for almost all the six countries. Among the six countries, Singapore has the longest history of integrated care, followed by Fiji, the Philippines, and China, while India and Vietnam have a shorter history of integrated care. Incentives, technologies, education, and performance evaluation would be crucial for developing strategies for implementing future programs and improve already existing programs. Conclusion: Integrated care is important for addressing challenges surrounding the delivery of long-term care. To date, there is an increasing trend of integrated care programs on chronic diseases in the Asia-Pacific region, and all six countries in our study set integrated care as a direction for their health systems transformation.

Keywords: integrated healthcare, integrated care delivery, chronic diseases, Asia-Pacific region

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Authors: John McDowall, Lucy Lightfoot

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Stigma constitutes a significant barrier to the recovery and social integration of individuals affected by mental illness. Although there is some debate in the literature regarding the definition and utility of stigma as a concept, it is widely accepted that it comprises three components: stereotypical beliefs, prejudicial reactions, and discrimination. Stereotypical beliefs describe the cognitive knowledge-based component of stigma, referring to beliefs (often negative) about members of a group that is based on cultural and societal norms (e.g. ‘People with anxiety are just weak’). Prejudice refers to the affective/evaluative component of stigma and describes the endorsement of negative stereotypes and the resulting negative emotional reactions (e.g. ‘People with anxiety are just weak, and they frustrate me’). Discrimination refers to the behavioural component of stigma, which is arguably the most problematic, as it exerts a direct effect on the stigmatized person and may lead people to behave in a hostile or avoidant way towards them (i.e. refusal to hire them). Research exploring anti-stigma initiatives focus primarily on an educational approach, with the view that accurate information will replace misconceptions and decrease stigma. Many approaches take a biogenetic stance, emphasising brain and biochemical deficits - the idea being that ‘mental illness is an illness like any other.' While this approach tends to effectively reduce blame, it has also demonstrated negative effects such as increasing prognostic pessimism, the desire for social distance and perceptions of stereotypes. In the present study 144 participants were split into three groups and read one of three vignettes presenting causal explanations for Generalised Anxiety Disorder (GAD): One explanation emphasized biogenetic factors as being important in the etiology of GAD, another emphasised psychosocial factors (e.g. aversive life events, poverty, etc.), and a third stressed the adaptive features of the disorder from an evolutionary viewpoint. A variety of measures tapping the various components of stigma were administered following the vignettes. No difference in stigma measures as a function of causal explanation was found. People who had contact with mental illness in the past were significantly less stigmatising across a wide range of measures, but this did not interact with the type of causal explanation.

Keywords: generalised anxiety disorder, discrimination, prejudice, stigma

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Authors: Shreya Saxena

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Background: Choledocholithiasis is a common complication of gallstone disease. Risk scoring systems exist to guide the need for further imaging or endoscopy in managing choledocholithiasis. We completed an audit to review the American Society for Gastrointestinal Endoscopy (ASGE) scoring system for prediction and management of choledocholithiasis against the current practice at a tertiary hospital to assess its utility in resource optimisation. We have now conducted a cost focused sub-analysis on patients categorized high-risk for choledocholithiasis according to the guidelines to determine any associated cost benefits. Method: Data collection from our prior audit was used to retrospectively identify thirteen patients considered high-risk for choledocholithiasis. Their ongoing management was mapped against the guidelines. Individual costs for the key investigations were obtained from our hospital financial data. Total cost for the different management pathways identified in clinical practice were calculated and compared against predicted costs associated with recommendations in the guidelines. We excluded the cost of laparoscopic cholecystectomy and considered a set figure for per day hospital admission related expenses. Results: Based on our previous audit data, we identified a77% positive predictive value for the ASGE risk stratification tool to determine patients at high-risk of choledocholithiasis. 47% (6/13) had an magnetic resonance cholangiopancreatography (MRCP) prior to endoscopic retrograde cholangiopancreatography (ERCP), whilst 53% (7/13) went straight for ERCP. The average length of stay in the hospital was 7 days, with an additional day and cost of £328.00 (£117 for ERCP) for patients awaiting an MRCP prior to ERCP. Per day hospital admission was valued at £838.69. When calculating total cost, we assumed all patients had admission bloods and ultrasound done as the gold standard. In doing an MRCP prior to ERCP, there was a 130% increase in cost incurred (£580.04 vs £252.04) per patient. When also considering hospital admission and the average length of stay, it was an additional £1166.69 per patient. We then calculated the exact costs incurred by the department, over a three-month period, for all patients, for key investigations or procedures done in the management of choledocholithiasis. This was compared to an estimate cost derived from the recommended pathways in the ASGE guidelines. Overall, 81% (£2048.45) saving was associated with following the guidelines compared to clinical practice. Conclusion: MRCP is the most expensive test associated with the diagnosis and management of choledocholithiasis. The ASGE guidelines recommend endoscopy without an MRCP in patients stratified as high-risk for choledocholithiasis. Our audit that focused on assessing the utility of the ASGE risk scoring system showed it to be relatively reliable for identifying high-risk patients. Our cost analysis has shown significant cost savings per patient and when considering the average length of stay associated with direct endoscopy rather than an additional MRCP. Part of this is also because of an increased average length of stay associated with waiting for an MRCP. The above data supports the ASGE guidelines for the management of high-risk for choledocholithiasis patients from a cost perspective. The only caveat is our small data set that may impact the validity of our average length of hospital stay figures and hence total cost calculations.

Keywords: cost-analysis, choledocholithiasis, risk stratification tool, general surgery

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Authors: Rong Li, Brian D. Wirth, Bing Liu

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Graphite is the matrix, and structural material in the high temperature gas-cooled reactor exhibits an irradiation response. It is of significant importance to analyze the defect production and evaluate the role of graphite under irradiation. A vast experimental literature exists for graphite on the dimensional change, mechanical properties, and thermal behavior. However, simulations have not been applied to the atomistic perspective. Remarkably few molecular dynamics simulations have been performed to study the irradiation response in graphite. In this paper, irradiation-induced damage cascades in graphite were investigated with molecular dynamics simulation. Statistical results of the graphite defects were obtained by sampling a wide energy range (1–30 KeV) and 10 different runs for every cascade simulation with different random number generator seeds to the velocity scaling thermostat function. The chemical bonding in carbon was described using the adaptive intermolecular reactive empirical bond-order potential (AIREBO) potential coupled with the standard Ziegler–Biersack–Littmack (ZBL) potential to describe close-range pair interactions. This study focused on analyzing the number of defects, the final cascade morphology and the distribution of defect clusters in space, the length-scale cascade properties such as the cascade length and the range of primary knock-on atom (PKA), and graphite mechanical properties’ variation. It can be concluded that the number of surviving Frenkel pairs increased remarkably with the increasing initial PKA energy but did not exhibit a thermal spike at slightly lower energies in this paper. The PKA range and cascade length approximately linearly with energy which indicated that increasing the PKA initial energy will come at expensive computation cost such as 30KeV in this study. The cascade morphology and the distribution of defect clusters in space mainly related to the PKA energy meanwhile the temperature effect was relatively negligible. The simulations are in agreement with known experimental results and the Kinchin-Pease model, which can help to understand the graphite damage cascades and lifetime span under irradiation and provide a direction to the designs of these kinds of structural materials in the future reactors.

Keywords: graphite damage cascade, molecular dynamics, cascade morphology, cascade distribution

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Authors: Ufuk Tosun, Reza Aghazadeh, Mehmet Bülent Özer

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This study puts forward a method to analyze the sloshing characteristics of liquid in a tuned sloshing absorber system by using image processing tools. Tuned sloshing vibration absorbers have recently attracted researchers’ attention as a seismic load damper in constructions due to its practical and logistical convenience. The absorber is liquid which sloshes and applies a force in opposite phase to the motion of structure. Experimentally characterization of the sloshing behavior can be utilized as means of verifying the results of numerical analysis. It can also be used to identify the accuracy of assumptions related to the motion of the liquid. There are extensive theoretical and experimental studies in the literature related to the dynamical and structural behavior of tuned sloshing dampers. In most of these works there are efforts to estimate the sloshing behavior of the liquid such as free surface motion and total force applied by liquid to the wall of container. For these purposes the use of sensors such as load cells and ultrasonic sensors are prevalent in experimental works. Load cells are only capable of measuring the force and requires conducting tests both with and without liquid to obtain pure sloshing force. Ultrasonic level sensors give point-wise measurements and hence they are not applicable to measure the whole free surface motion. Furthermore, in the case of liquid splashing it may give incorrect data. In this work a method for evaluating the sloshing wave height by using camera records and image processing techniques is presented. In this method the motion of the liquid and its container, made of a transparent material, is recorded by a high speed camera which is aligned to the free surface of the liquid. The video captured by the camera is processed frame by frame by using MATLAB Image Processing toolbox. The process starts with cropping the desired region. By recognizing the regions containing liquid and eliminating noise and liquid splashing, the final picture depicting the free surface of liquid is achieved. This picture then is used to obtain the height of the liquid through the length of container. This process is verified by ultrasonic sensors that measured fluid height on the surface of liquid.

Keywords: fluid structure interaction, image processing, sloshing, tuned liquid damper

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Authors: Seba Mohanty, Jitendra Mahakud

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Capital ratio is one of the major indicators of the stability of the commercial banks. Pertinent to its pervasive importance, over the years the regulators, policy makers focus on the maintenance of the particular level of capital ratio to minimize the solvency and liquidation risk. In this context, it is very much important to identify the relationship between capital and risk and find out the factors which determine the capital ratios of commercial banks. The study examines the relationship between capital and risk of the commercial banks operating in India. Other bank specific variables like bank size, deposit, profitability, non-performing assets, bank liquidity, net interest margin, loan loss reserves, deposits variability and regulatory pressure are also considered for the analysis. The period of study is 1997-2015 i.e. the period of post liberalization. To identify the impact of financial crisis and implementation of Basel II on capital ratio, we have divided the whole period into two sub-periods i.e. 1997-2008 and 2008-2015. This study considers all the three types of commercial banks, i.e. public sector, the private sector and foreign banks, which have continuous data for the whole period. The main sources of data are Prowess data base maintained by centre for monitoring Indian economy (CMIE) and Reserve Bank of India publications. We use simultaneous equation model and more specifically Two Stage Least Square method to find out the relationship between capital and risk. From the econometric analysis, we find that capital and risk affect each other simultaneously, and this is consistent across the time period and across the type of banks. Moreover, regulation has a positive significant impact on the ratio of capital to risk-weighted assets, but no significant impact on the banks risk taking behaviour. Our empirical findings also suggest that size has a negative impact on capital and risk, indicating that larger banks increase their capital less than the other banks supported by the too-big-to-fail hypothesis. This study contributes to the existing body of literature by predicting a strong relationship between capital and risk in an emerging economy, where banking sector plays a majority role for financial development. Further this study may be considered as a primary study to find out the macro economic factors which affecting risk and capital in India.

Keywords: capital, commercial bank, risk, simultaneous equation model

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Authors: Vladyslav Povoroznyuk, Nataliia Dzerovych, Larysa Martynyuk, Tetiana Kovtun

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Obesity and osteoporosis are the two diseases whose increasing prevalence and high impact on the global morbidity and mortality, during the two recent decades, have gained a status of major health threats worldwide. Obesity purports to affect the bone metabolism through complex mechanisms. Debated data on the connection between the bone mineral density and fracture prevalence in the obese patients are widely presented in literature. There is evidence that the correlation of weight and fracture risk is site-specific. The aim of this study was to evaluate the Bone Mineral Density (BMD) and Trabecular Bone Score (TBS) in the obese Ukrainian women. We examined 1025 40-89-year-old women, divided them into the groups according to their body mass index: Group a included 360 women with obesity whose BMI was ≥30 kg/m2, and Group B – 665 women with no obesity and BMI of < 30 kg/m2. The BMD of total body, lumbar spine at the site L1-L4, femur and forearm were measured by DXA (Prodigy, GEHC Lunar, Madison, WI, USA). The TBS of L1-L4 was assessed by means of TBS iNsight® software installed on our DXA machine (product of Med-Imaps, Pessac, France). In general, obese women had a significantly higher BMD of lumbar spine, femoral neck, proximal femur, total body, and ultradistal forearm (p<0.001) in comparison with women without obesity. The TBS of L1-L4 was significantly lower in obese women compared to non-obese women (p<0.001). The BMD of lumbar spine, femoral neck and total body differed to a significant extent in women of 40-49, 50-59, 60-69, and 70-79 years (p<0.05). At same time, in women aged 80-89 years the BMD of lumbar spine (p=0.09), femoral neck (p=0.22) and total body (p=0.06) barely differed. The BMD of ultradistal forearm was significantly higher in women of all age groups (p<0.05). The TBS of L1-L4 in all the age groups tended to reveal the lower parameters in obese women compared with the non-obese; however, those data were not statistically significant. By contrast, a significant positive correlation was observed between the fat mass and the BMD at different sites. The correlation between the fat mass and TBS of L1-L4 was also significant, although negative. Women with vertebral fractures had a significantly lower body weight, body mass index and total body fat mass in comparison with women without vertebral fractures in their anamnesis. In obese women the frequency of vertebral fractures was 27%, while in women without obesity – 57%.

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

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Authors: Paolino Di Felice

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The background and significance of this study come from papers already appeared in the literature which measured the impact of public services (e.g., hospitals, schools, ...) on the citizens’ needs satisfaction (one of the dimensions of QOL studies) by calculating the distance between the place where they live and the location on the territory of the services. Those studies assume that the citizens' dwelling coincides with the centroid of the polygon that expresses the boundary of the administrative district, within the city, they belong to. Such an assumption “introduces a maximum measurement error equal to the greatest distance between the centroid and the border of the administrative district.”. The case study, this abstract reports about, investigates the implications descending from the adoption of such an approach but at geographical scales greater than the urban one, namely at the three levels of nesting of the Italian administrative units: the (20) regions, the (110) provinces, and the 8,094 municipalities. To carry out this study, it needs to be decided: a) how to store the huge amount of (spatial and descriptive) input data and b) how to process them. The latter aspect involves: b.1) the design of algorithms to investigate the geometry of the boundary of the Italian administrative units; b.2) their coding in a programming language; b.3) their execution and, eventually, b.4) archiving the results in a permanent support. The IT solution we implemented is centered around a (PostgreSQL/PostGIS) Geo DataBase structured in terms of three tables that fit well to the hierarchy of nesting of the Italian administrative units: municipality(id, name, provinceId, istatCode, regionId, geometry) province(id, name, regionId, geometry) region(id, name, geometry). The adoption of the DBMS technology allows us to implement the steps "a)" and "b)" easily. In particular, step "b)" is simplified dramatically by calling spatial operators and spatial built-in User Defined Functions within SQL queries against the Geo DB. The major findings coming from our experiments can be summarized as follows. The approximation that, on the average, descends from assimilating the residence of the citizens with the centroid of the administrative unit of reference is of few kilometers (4.9) at the municipalities level, while it becomes conspicuous at the other two levels (28.9 and 36.1, respectively). Therefore, studies such as those mentioned above can be extended up to the municipal level without affecting the correctness of the interpretation of the results, but not further. The IT framework implemented to carry out the experiments can be replicated for studies referring to the territory of other countries all over the world.

Keywords: quality of life, distance measurement error, Italian administrative units, spatial database

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Authors: Sean Yao Zu Kong, Khong Yik Chew

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Introduction: We described a case report of the successful use of advanced surgical techniques in a patient with recurrent breast cancer who underwent a wide resection including the hemi-sternum, clavicle, multiple ribs, and a lobe of the lung due to tumor involvement. This extensive resection exposed critical structures, requiring a creative approach to reconstruction. To address this complex chest wall reconstruction, a free fibula flap and a 4-zone rectus abdominis musculocutaneous flap were successfully utilized. The use of a free vascularized bone flap allowed for rapid osteointegration and resistance against osteoradionecrosis after adjuvant radiation, while a four-zone tram flap allowed for reconstruction of both the chest wall and breast mound. Although limited recipient vessels made free flaps challenging, the free fibula flap served as both a bony reconstruction and vascular conduit, supercharged with the distal peroneal artery and veins of the peroneal artery from the fibula graft. Our approach highlights the potential of advanced surgical techniques to improve outcomes in complex cases of chest wall reconstruction in patients with recurrent breast cancer, which is becoming increasingly relevant as breast cancer incidence rates increases. Case presentation: This report describes a successful reconstruction of a patient with recurrent breast cancer who required extensive resection, including the anterior chest wall, clavicle, and sternoclavicular joint. Challenges arose due to the loss of accessory muscles and the non-rigid rib cage, which could lead to compromised ventilation and instability. A free fibula osteocutaneous flap and a four-zone TRAM flap with vascular supercharging were utilized to achieve long-term stability and function. The patient has since fully recovered, and during the review, both flaps remained viable, and chest mound reconstruction was satisfactory. A planned nipple/areolar reconstruction was offered pending the patient’s decision after adjuvant radiotherapy. Conclusion: In conclusion, this case report highlights the successful use of innovative surgical techniques in addressing a complex case of recurrent breast cancer requiring extensive resection and radical reconstruction. Our approach, utilized a combination of a free fibula flap and a 4-zone rectus abdominis musculocutaneous flap, demonstrates the potential for advanced techniques in chest wall reconstruction to minimize complications and ensure long-term stability and function. As the incidence of breast cancer continues to rise, it is crucial that healthcare professionals explore and utilize innovative techniques to improve patient outcomes and quality of life.

Keywords: free fibula flap, rectus abdominis musculocutaneous flap, post-adjuvant radiotherapy, reconstructive surgery, malignancy

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Authors: Richard Harrison

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Developing competency in mathematics and related critical thinking skills is essential to the education of undergraduate students of Science, Technology, Engineering and Mathematics (STEM). Recently, the HE sector has been impacted by a seemingly widening disconnect between the mathematical competency of incoming first-year STEM students and their entrance qualification tariffs. Despite relatively high grades in A-Level Mathematics, students may initially lack fundamental skills in key areas such as algebraic manipulation and have limited capacity to apply problem solving strategies. Compounded by compensatory measures applied to entrance qualifications during the pandemic, there has been an associated decline in student performance on introductory university mathematics modules. In the UK, a number of online resources have been developed to help scaffold the transition to university mathematics. However, in general, these do not offer a structured learning journey focused on individual developmental needs, nor do they offer an experience coherent with the teaching and learning characteristics of the destination institution. In order to address some of these issues, a bespoke framework has been designed and implemented on our VLE in the Faculty of Engineering & Physical Sciences (FEPS) at the University of Surrey. Called the FEPS Maths Support Framework, it was conceived to scaffold the mathematical development of individuals prior to entering the university and during the early stages of their transition to undergraduate studies. More than 90% of our incoming STEM students voluntarily participate in the process. Students complete a set of initial diagnostic questions in the late summer. Based on their performance and feedback on these questions, they are subsequently guided to self-select specific mathematical topic areas for review using our proprietary resources. This further assists students in preparing for discipline related diagnostic tests. The framework helps to identify students who are mathematically weak and facilitates early intervention to support students according to their specific developmental needs. This paper presents a summary of results from a rich data set captured from the framework over a 3-year period. Quantitative data provides evidence that students have engaged and developed during the process. This is further supported by process evaluation feedback from the students. Ranked performance data associated with seven key mathematical topic areas and eight engineering and science discipline areas reveals interesting patterns which can be used to identify more generic relative capabilities of the discipline area cohorts. In turn, this facilitates evidence based management of the mathematical development of the new cohort, informing any associated adjustments to teaching and learning at a more holistic level. Evidence is presented establishing our framework as an effective early intervention strategy for addressing the sector-wide issue of supporting the mathematical development of STEM students transitioning to HE

Keywords: competency, development, intervention, scaffolding

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Authors: Yan Yan, Erhong Sun, Lin Peng, Xuchun Ye

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Aims: The present study aimed to explore Intensive Care Unit (ICU) nurses’ mental workload (MWL) and associated factors with it in performing human-machine tasks. Background: A wide range of emerging technologies have penetrated widely in the field of health care, and ICU nurses are facing a dramatic increase in nursing human-machine tasks. However, there is still a paucity of literature reporting on the general MWL of ICU nurses performing human-machine tasks and the associated influencing factors. Methods: A cross-sectional survey was employed. The data was collected from January to February 2021 from 9 tertiary hospitals in 6 provinces (Shanghai, Gansu, Guangdong, Liaoning, Shandong, and Hubei). Two-stage sampling was used to recruit eligible ICU nurses (n=427). The data were collected with an electronic questionnaire comprising sociodemographic characteristics and the measures of MWL, self-efficacy, system usability, and task difficulty. The univariate analysis, two-way analysis of variance (ANOVA), and a linear mixed model were used for data analysis. Results: Overall, the mental workload of ICU nurses in performing human-machine tasks was medium (score 52.04 on a 0-100 scale). Among the typical nursing human-machine tasks selected, the MWL of ICU nurses in completing first aid and life support tasks (‘Using a defibrillator to defibrillate’ and ‘Use of ventilator’) was significantly higher than others (p < .001). And ICU nurses’ MWL in performing human-machine tasks was also associated with age (p = .001), professional title (p = .002), years of working in ICU (p < .001), willingness to study emerging technology actively (p = .006), task difficulty (p < .001), and system usability (p < .001). Conclusion: The MWL of ICU nurses is at a moderate level in the context of a rapid increase in nursing human-machine tasks. However, there are significant differences in MWL when performing different types of human-machine tasks, and MWL can be influenced by a combination of factors. Nursing managers need to develop intervention strategies in multiple ways. Implications for practice: Multidimensional approaches are required to perform human-machine tasks better, including enhancing nurses' willingness to learn emerging technologies actively, developing training strategies that vary with tasks, and identifying obstacles in the process of human-machine system interaction.

Keywords: mental workload, nurse, ICU, human-machine, tasks, cross-sectional study, linear mixed model, China

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Authors: Tanvir A. Uddin, Blake Goud

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Emerging trends in FinTech-enabled alternative finance, which includes channels and instruments emerging outside the traditional financial system, heralds unprecedented opportunities to improve financial intermediation and increase access to finance. With widespread criticism of the mainstream Islamic banking and finance sector as either mimicking the conventional system, failing to achieve inclusive growth or both, industry stakeholders are turning to technology to show that finance can be done differently. This paper will outline the critical elements for successful deployment of technology to maximize benefit and minimize potential for harm from introduction of Islamic FinTech and propose recommendations for Islamic financial institutions, FinTech companies, regulators and other stakeholders who are integrating or who are considering introducing FinTech solutions. The paper will present an overview of literature, present relevant case studies and summarize the lessons from interviews conducted with Islamic FinTech founders from around the world. With growing central bank concerns about leveraged loans and ballooning private credit markets globally (estimated at $1.4 trillion), current and future Islamic FinTech operators are at risk of contributing to the problems they aim to solve by operating in a 'shadow banking' system. The paper will show that by systematising a robust theory of change linked to positive outcomes, utilising objective impact frameworks (e.g., the Impact Measurement Project) and instilling a risk management culture that is proactive about potential social harm (e.g., irresponsible lending), FinTech can enable the Islamic finance industry to support positive social impact and minimize harm in support of the maqasid. The adoption of FinTech within the Islamic finance context is still at a nascent stage and the recommendations we provide based on the limited experience to date will help address some of the major cross-cutting issues related to FinTech. Further research will be needed to elucidate in more detail issues relating to individual sectors and countries within the broader global Islamic finance industry.

Keywords: alternative finance, FinTech, Islamic finance, maqasid, theory of change

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Authors: Georges Jabbour

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Background and aims: This two-year follow-up study explores the long-term sustainability of physical activity (PA) levels in young people with type 1 diabetes, focusing on the relationship between PA, hypoglycemia, and behavioral scores. The literature highlights the importance of PA and its health benefits, as well as the barriers to engaging in PA practices. Studies have shown that individuals with high levels of vigorous physical activity have higher fear of hypoglycemia (FOH) scores and more hypoglycemia episodes. Considering that hypoglycemia episodes are a major barrier to physical activity, and many studies reported a negative association between PA and high FOH scores, it cannot be guaranteed that those experiencing hypoglycemia over a long period will remain active. Building on that, the present work assesses whether high PA levels, despite elevated hypoglycemia risk, can be maintained over time. The study tracks PA levels at one and two years, correlating them with hypoglycemia instances and Fear of Hypoglycemia (FOH) scores. Materials and methods: A self-administered questionnaire was completed by 61 youth with T1D, and their PA was assessed. Hypoglycemia episodes, fear of hypoglycemia scores and HbA1C levels were collected. All assessments were realized at baseline (visit 0: V0), one year (V1) and two years later (V2). For the purpose of the present work, we explore the relationships between PA levels, hypoglycemia episodes, and FOH scores at each time point. We used multiple linear regression to model the mean outcomes for each exposure of interest. Results: Findings indicate no changes in total moderate to vigorous PA (MVPA) and VPA levels among visits, and HbA1c (%) was negatively correlated with the total amount of VPA per day in minutes (β= -0.44; p=0.01, β= -0.37; p=0.04, and β= -0.66; p=0.01 for V0, V1, and V2, respectively). Our linear regression model reported a significant negative correlation between VPA and FOH across the visits (β=-0.59, p=0.01; β= -0.44, p=0.01; and β= -0.34, p=0.03 for V0, V1, and V2, respectively), and HbA1c (%) was influenced by both the number of hypoglycemic episodes and FOH score at V2 (β=0.48; p=0.02 and β=0.38; p=0.03, respectively). Conclusion: The sustainability of PA levels and HbA1c (%) in young individuals with type 1 diabetes is influenced by various factors, including fear of hypoglycemia. Understanding these complex interactions is essential for developing effective interventions to promote sustained PA levels in this population. Our results underline the necessity of a multi-strategic approach to promoting active lifestyles among diabetic youths. This approach should synergize PA enhancement with vigilant glucose monitoring and effective FOH management.

Keywords: physical activity, hypoglycemia, fear of hypoglycemia, youth

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Authors: Neeraj Vij, Amber Brennan, Jenni Winters, Hadi Salehi, Hamy Temkit, Emily Andrisevic, Mohan V. Belthur

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Idiopathic clubfoot is a common lower extremity deformity with an incidence of 1:500. The Ponseti Method is well known as the gold standard of treatment. However, there is limited functional data demonstrating correction of the clubfoot after treatment with the Ponseti method. The purpose of this study was to study the clinical and functional outcomes after the Ponseti method with the Clubfoot Disease-Specific Instrument (CDS) and pedobarography. This IRB-approved prospective study included patients aged 3-18 who were treated for idiopathic clubfoot with the Ponseti method between January 2008 and December 2018. Age-matched controls were identified through siblings of clubfoot patients and other community members. Treatment details were collected through a chart review of the included patients. Laboratory assessment included a physical exam, gait analysis, and pedobarography. The Pediatric Outcomes Data Collection Instrument and the Clubfoot Disease-Specific Instrument were also obtained on clubfoot patients (CF). The Wilcoxson rank-sum test was used to study differences between the CF patients and the typically developing (TD) patients. Statistical significance was set at p < 0.05. There were a total of 37 enrolled patients in our study. 21 were priorly treated for CF and 16 were TD. 94% of the CF patients had bilateral involvement. The age at the start of treatment was 29 days, the average total number of casts was seven to eight, and the average total number of casts after Achilles tenotomy was one. The reoccurrence rate was 25%, tenotomy was required in 94% of patients, and ≥1 tenotomy was required in 25% of patients. There were no significant differences between step length, step width, stride length, force-time integral, maximum peak pressure, foot progression angles, stance phase time, single-limb support time, double limb support time, and gait cycle time between children treated with the Ponseti method and typically developing children. The average post-treatment Pirani and Dimeglio scores were 5.50±0.58 and 15.29±1.58, respectively. The average post-treatment PODCI subscores were: Upper Extremity: 90.28, Transfers: 94.6, Sports: 86.81, Pain: 86.20, Happiness: 89.52, Global: 88.6. The average post-treatment Clubfoot Disease-Specific Instrument scores subscores were: Satisfaction: 73.93, Function: 80.32, Overall: 78.41. The Ponseti Method has a very high success rate and remains to be the gold standard in the treatment of idiopathic clubfoot. Timely management leads to good outcomes and a low need for repeated Achilles tenotomy. Children treated with the Ponseti method demonstrate good functional outcomes as measured through pedobarography. Pedobarography may have clinical utility in studying congenital foot deformities. Objective measures for hours of brace wear could represent an improvement in clubfoot care.

Keywords: functional outcomes, pediatric deformity, patient-reported outcomes, talipes equinovarus

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Authors: Zahra Hamidi

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Promoting cycling, as an affordable environmentally friendly mode of transport to replace private car use has been central to sustainable transport policies. Cycling is faster than walking and combined with public transport has the potential to extend the opportunities that people can access. In other words, cycling, besides direct positive health impacts, can improve people mobility and ultimately their quality of life. Transport literature well supports the close relationship between mobility, quality of life, and, well being. At the same time inequity in the distribution of access and mobility has been associated with the key aspects of injustice and social exclusion. The pattern of social exclusion and inequality in access are also often related to population characteristics such as age, gender, income, health, and ethnic background. Therefore, while investing in transport infrastructure it is important to consider the equity of provided access for different population groups. This paper proposes a method to evaluate the equity of cycling in a city from Rawls egalitarian perspective. Since this perspective is concerned with the difference between individuals and social groups, this method combines accessibility measures and Theil index of inequality that allows capturing the inequalities ‘within’ and ‘between’ groups. The paper specifically focuses on two population characteristics as gender and ethnic background. Following Rawls equity principles, this paper measures accessibility by bikes to a selection of urban activities that can be linked to the concept of the social primary goods. Moreover, as growing number of cities around the world have launched bike-sharing systems (BSS) this paper incorporates both private and public bikes networks in the estimation of accessibility levels. Additionally, the typology of bike lanes (separated from or shared with roads), the presence of a bike sharing system in the network, as well as bike facilities (e.g. parking racks) have been included in the developed accessibility measures. Application of this proposed method to a real case study, the city of Malmö, Sweden, shows its effectiveness and efficiency. Although the accessibility levels were estimated only based on gender and ethnic background characteristics of the population, the author suggests that the analysis can be applied to other contexts and further developed using other properties, such as age, income, or health.

Keywords: accessibility, cycling, equity, gender

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Authors: I. Stacher, B. Schrank, K. Stiehl, K. A. Woodcock

Abstract:

Background: The need and desire for connectedness and belonging to a peer group is a major concern in middle childhood. This is particularly true for the period of school transition when making and maintaining friendships is put to the test. Social relations are important for enhancing self-esteem, confidence, and mental health. Conflicts with peers and victimization mark challenges in the complex social environment of early adolescents. Thus, the promotion of supportive peer relationships is an important social goal. The current literature lacks an in-depth analysis of young people’s experiences connected to making and maintaining friendships. Aim: This qualitative study aims to understand the factors that facilitate and hinder friendship and peer relations within the complex context of school transition. Methods: Youth engagement workshops at primary and secondary schools were conducted with 53 classes (N = 906 pupils; M age = 10.44; SD = .912) in 29 different schools across lower Austria. A big poster was created with the entire class, collecting early adolescents’ ideas on ways they can support each other in the school environment. Then, students were divided into smaller groups and encouraged to share their personal experiences of friendship. Verbatim quotes from students were collected on observation sheets and sticky notes during the activities. A thematic analysis was conducted. Results: Early adolescents describe facilitating factors that allow them to connect with peers. These descriptions are mainly on a behavioral level and are relevant for face-to-face and digital contact, e.g., practical and emotional support, spending time together, pleasure and fun. Specific challenges such as offensive actions, betrayal, and lack of emotion regulation exist and need to be addressed if aiming to reduce barriers between peers. Conclusion: Knowing first-hand experiences, desires, and barriers for making and maintaining friends at the time of school transition will help researchers to develop preventive health programs that adequately address the needs and preferences of today’s youth.

Keywords: youth voice, experts by experience, friendship, peer relations, primary-secondary school, transition

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