Search results for: geographic bias
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1374

Search results for: geographic bias

504 Analyzing Apposition and the Typology of Specific Reference in Newspaper Discourse in Nigeria

Authors: Monday Agbonica Bello Eje

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The language of the print media is characterized by the use of apposition. This linguistic element function strategically in journalistic discourse where it is communicatively necessary to name individuals and provide information about them. Linguistic studies on the language of the print media with bias for apposition have largely dwelt on other areas but the examination of the typology of appositive reference in newspaper discourse. Yet, it is capable of revealing ways writers communicate and provide information necessary for readers to follow and understand the message. The study, therefore, analyses the patterns of appositional occurrences and the typology of reference in newspaper articles. The data were obtained from The Punch and Daily Trust Newspapers. A total of six editions of these newspapers were collected randomly spread over three months. News and feature articles were used in the analysis. Guided by the referential theory of meaning in discourse, the appositions identified were subjected to analysis. The findings show that the semantic relation of coreference and speaker coreference have the highest percentage and frequency of occurrence in the data. This is because the subject matter of news reports and feature articles focuses on humans and the events around them; as a result, readers need to be provided with some form of detail and background information in order to identify as well as follow the discourse. Also, the non-referential relation of absolute synonymy and speaker synonymy no doubt have fewer occurrences and percentages in the analysis. This is tied to a major feature of the language of the media: simplicity. The paper concludes that appositions is mainly used for the purpose of providing the reader with much detail. In this way, the writer transmits information which helps him not only to give detailed yet concise descriptions but also in some way help the reader to follow the discourse.

Keywords: apposition, discourse, newspaper, Nigeria, reference

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503 The Evolution Characteristics of Urban Ecological Patterns in Parallel Range-Valley Areas, China

Authors: Wen Feiming

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As the ecological barrier of the Yangtze River, the ecological security of the Parallel Range-Valley area is very important. However, the unique geomorphic features aggravate the contradiction between man and land, resulting in the encroachment of ecological space. In recent years , relevant researches has focused on the single field of land science, ecology and landscape ecology, and it is difficult to systematically reflect the regularities of distribution and evolution trends of ecological patterns in the process of urban development. Therefore, from the perspective of "Production-Living-Ecological space", using spatial analysis methods such as Remote Sensing (RS) and Geographic Information Systems (GIS), this paper analyzes the evolution characteristics and driving factors of the ecological pattern of mountain towns in the parallel range-valley region from the aspects of land use structure, change rate, transformation relationship, and spatial correlation. It is concluded that the ecological pattern of mountain towns presents a trend from expansion and diffusion to agglomeration, and the dynamic spatial transfer is a trend from artificial transformation to the natural origin, while the driving effect analysis shows the significant characteristics of terrain attraction and construction barrier. Finally, combined with the evolution characteristics and driving mechanism, the evolution modes of "mountain area - concentrated growth", "trough area - diffusion attenuation" and "flat area - concentrated attenuation" are summarized, and the differentiated zoning and stratification ecological planning strategies are proposed here, in order to provide the theoretical basis for the sustainable development of mountain towns in parallel range-valley areas.

Keywords: parallel range-valley, ecological pattern, evolution characteristics, driving factors

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502 Spatio-Temporal Analysis of Drought in Cholistan Region, Pakistan: An Application of Standardized Precipitation Index

Authors: Qurratulain Safdar

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Drought is a temporary aberration in contrast to aridity, as it is a permanent feature of climate. Virtually, it takes place in all types of climatic regions that range from high to low rainfall areas. Due to the wide latitudinal extent of Pakistan, there is seasonal and annual variability in rainfall. The south-central part of the country is arid and hyper-arid. This study focuses on the spatio-temporal analysis of droughts in arid and hyperarid region of Cholistan using the standardized precipitation index (SPI) approach. This study has assessed the extent of recurrences of drought and its temporal vulnerability to drought in Cholistan region. Initially, the paper described the geographic setup of the study area along with a brief description of the drought conditions that prevail in Pakistan. The study also provides a scientific foundation for preparing literature and theoretical framework in-line with the selected parameters and indicators. Data were collected both from primary and secondary data sources. Rainfall and temperature data were obtained from Pakistan Meteorology Department. By applying geostatistical approach, a standardized precipitation index (SPI) was calculated for the study region, and the value of spatio-temporal variability of drought and its severity was explored. As a result, in-depth spatial analysis of drought conditions in Cholistan area was found. Parallel to this, drought-prone areas with seasonal variation were also identified using Kriging spatial interpolation techniques in a GIS environment. The study revealed that there is temporal variation in droughts' occurrences both in time series and SPI values. The paper is finally concluded, and strategic plan was suggested to minimize the impacts of drought.

Keywords: Cholistan desert, climate anomalies, metrological droughts, standardized precipitation index

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501 Comparative Study of Conventional and Satellite Based Agriculture Information System

Authors: Rafia Hassan, Ali Rizwan, Sadaf Farhan, Bushra Sabir

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The purpose of this study is to compare the conventional crop monitoring system with the satellite based crop monitoring system in Pakistan. This study is conducted for SUPARCO (Space and Upper Atmosphere Research Commission). The study focused on the wheat crop, as it is the main cash crop of Pakistan and province of Punjab. This study will answer the following: Which system is better in terms of cost, time and man power? The man power calculated for Punjab CRS is: 1,418 personnel and for SUPARCO: 26 personnel. The total cost calculated for SUPARCO is almost 13.35 million and CRS is 47.705 million. The man hours calculated for CRS (Crop Reporting Service) are 1,543,200 hrs (136 days) and man hours for SUPARCO are 8, 320hrs (40 days). It means that SUPARCO workers finish their work 96 days earlier than CRS workers. The results show that the satellite based crop monitoring system is efficient in terms of manpower, cost and time as compared to the conventional system, and also generates early crop forecasts and estimations. The research instruments used included: Interviews, physical visits, group discussions, questionnaires, study of reports and work flows. A total of 93 employees were selected using Yamane’s formula for data collection, which is done with the help questionnaires and interviews. Comparative graphing is used for the analysis of data to formulate the results of the research. The research findings also demonstrate that although conventional methods have a strong impact still in Pakistan (for crop monitoring) but it is the time to bring a change through technology, so that our agriculture will also be developed along modern lines.

Keywords: area frame, crop reporting service, CRS, sample frame, SRS/GIS, satellite remote sensing/ geographic information system

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500 Review of the Road Crash Data Availability in Iraq

Authors: Abeer K. Jameel, Harry Evdorides

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Iraq is a middle income country where the road safety issue is considered one of the leading causes of deaths. To control the road risk issue, the Iraqi Ministry of Planning, General Statistical Organization started to organise a collection system of traffic accidents data with details related to their causes and severity. These data are published as an annual report. In this paper, a review of the available crash data in Iraq will be presented. The available data represent the rate of accidents in aggregated level and classified according to their types, road users’ details, and crash severity, type of vehicles, causes and number of causalities. The review is according to the types of models used in road safety studies and research, and according to the required road safety data in the road constructions tasks. The available data are also compared with the road safety dataset published in the United Kingdom as an example of developed country. It is concluded that the data in Iraq are suitable for descriptive and exploratory models, aggregated level comparison analysis, and evaluation and monitoring the progress of the overall traffic safety performance. However, important traffic safety studies require disaggregated level of data and details related to the factors of the likelihood of traffic crashes. Some studies require spatial geographic details such as the location of the accidents which is essential in ranking the roads according to their level of safety, and name the most dangerous roads in Iraq which requires tactic plan to control this issue. Global Road safety agencies interested in solve this problem in low and middle-income countries have designed road safety assessment methodologies which are basing on the road attributes data only. Therefore, in this research it is recommended to use one of these methodologies.

Keywords: road safety, Iraq, crash data, road risk assessment, The International Road Assessment Program (iRAP)

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499 Retrospective Statistical Study on the Evolution of Brucellosis during the Last Decade (2011-2021) in Medea, Algeria

Authors: Mammar Khames, Mustapha Oumouna

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Brucellosis is one of the most common zoonoses in the world. It represents a serious threat to human health; the existence of brucellosis in Algeria dates back to the beginning of the 19th century. Its transmission to humans is through coccobacilli of the genus Brucella following direct contact with contaminated animals or indirectly through the consumption of their unpasteurized dairy products. The present investigation covers a retrospective study on human brucellosis in the district of Medea over a period from 2011 to 2021 at the level of two public health establishments. In the first place, it is at the level of the Directorate of Public Health and in the infectious department level at Medea Hospital, and at the level of the directorate of agricultural services in the third place. The results showed that during these eleven years of study, 795 cases were collected from the department of health and population, and 141 cases were collected from the infectious department of the district of Medea. A total of 56 cases of bovine brucellosis were obtained from the directorate of agricultural services of the district of Medea. Human brucellosis affects all age groups with different percentages, but the rate has been higher in the 20-44 age group, with a predominance of men. However, the geographic distribution map of the cases shows that the western part of the district was the most affected. A cohort of 141 cases was hospitalized at the infectious service level of Medea Hospital. They were 89 men and 52 women. The most common age reached is [20-44] years. The majority were of rural origin. Two serological reactions were performed for diagnosis: the buffered antigen test and Wright's serodiagnosis. Bovine brucellosis affects all age groups with different percentages, but the rate was higher in the 2-to-4-year age group, with a predominance of females. From these data, we conclude that brucellosis has a strong spread in the region studied.

Keywords: human brucellosis, serology, Medea, Algeria

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498 Geographic Information System Based Development Potentiality Assessment for Rural Villages: Case Study in Fuliang County, Jingdezhen

Authors: Sishen Wang

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Chinese rural industry development is the major task currently during rapid urbanization. Development of potentiality assessment, evaluate the overall suitability of each village for further industrial development, could offer reference for policy makers, especially considering the limited data available in Chinese rural regions. The study focuses on 157 official villages in Fuliang County and evaluates their development potentiality by their topography, transportation condition, population, income of villagers, infrastructure and environmental conditions. Land cover changes for Fuliang county and surrounding areas of each village is also investigated for reference. The final development potentiality of each village was calculated by adding different weighted scores of different categories. Besides, inverse distance weighting (IDW) images for both final score of development potentiality and each factor were made and compared to help to understand the final result. The study found that village in the southern and northern regions have higher development potentiality than villages in the eastern and western regions, mainly because of higher income of villagers, good accessibilities and a large amount of population size. In addition, the Fuliang county was divided into five regions based on final result and policy reference for the development of each region were put forward individually. In addition, three suggestions were made for better local development potentiality: Firstly, the transportation accessibility needs to be improved in the northern regions by building more public transit system there. Secondly, the environmental conditions and infrastructure conditions in the eastern region of the county need some improvement. Thirdly, some encouragement and job opportunities should beset up in the western regions to attract labor force to move in and settle down.

Keywords: development potentiality, Fuliang GIS-Based, GIS, official village

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497 Sex Difference of the Incidence of Sudden Cardiac Arrest/Death in Athletes: A Systematic Review and Meta-analysis

Authors: Lingxia Li, Frédéric Schnell, Shuzhe Ding, Solène Le Douairon Lahaye

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Background: The risk of sudden cardiac arret/death (SCA/D) in athletes is controversial. There is a lack of meta-analyses assessing the sex differences in the risk of SCA/D in competitive athletes. Purpose: The aim of the present study was to evaluate sex differences in the incidence of SCA/D in competitive athletes using meta-analyses. Methods: The systematic review was registered in the PROSPERO database (registration ID: CRD42023432022) and was conducted according to the PRISMA guidelines. PubMed, Embase, Scopus, SPORT Discus and Cochrane Library were searched up to July 2023. To avoid systematic bias in data pooling, only studies with data for both sexes were included. Results: From the 18 included studies, 2028 cases of SCA/D were observed (males 1821 (89.79%), females 207 (10.21%)). The age ranges from the adolescents (<26 years) to the elderly (>45 years). The incidence in male athletes was 1.32/100,000 AY (95% CI: [0.90, 1.93]) and in females was 0.26/100,000 AY (95% CI: [0.16, 0.43]), the incidence rate ratio (IRR) was 6.43 (95% CI: [4.22, 9.79]). The subgroup synthesis showed a higher incidence in males than in females in both age groups <25 years and ≤35 years, the IRR was 5.86 (95% CI: [4.69, 7.32]) and 5.79 (95% CI: [4.73, 7.09]), respectively. When considering the events, the IRR was 6.73 (95%CI: [3.06, 14.78]) among studies involving both SCA/D events and 7.16 (95% CI: [4.93, 10.40]) among studies including only cases of SCD. The available clinical evidence showed that cardiac events were most frequently seen in long-distance running races (26, 35.1%), marathon (16, 21.6%) and soccer (10, 13.5%). Coronary artery disease (14, 18.9%), hypertrophic cardiomyopathy (8, 10.8%), and arrhythmogenic right ventricular cardiomyopathy (7, 9.5%) are the most common causes of SCA/D in competitive athletes. Conclusion: The meta-analysis provides evidence of sex differences in the incidence of SCA/D in competitive athletes. The incidence of SCA/D in male athletes was 6 to 7 times higher than in females. Identifying the reasons for this difference may have implications for targeted the prevention of fatal evets in athletes.

Keywords: incidence, sudden cardiac arrest, sudden cardiac death, sex difference, athletes

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496 The Influence of Group Heuristics on Corporate Social Responsibility Messages Designed to Reduce Illegal Consumption

Authors: Kate Whitman, Zahra Murad, Joe Cox

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Corporate social responsibility projects are suggested to motivate consumers to reciprocate good corporate deeds with their custom. When the projects benefit the ingroup vs the outgroup, such as locals rather than foreigners, the effect on reciprocity is suggested to be more powerful. This may be explained by group heuristics, a theory which indicates that favours to the ingroup (but not outgroup) are expected to be reciprocated, resulting in ingroup favouritism. The heuristic is theorised to explain prosocial behaviours towards the ingroup. The aim of this study is to test whether group heuristics similarly explain a reduction in antisocial behaviours towards the ingroup, measured by illegal consumption which harms a group that consumers identify with. In order to test corporate social responsibility messages, a population of interested consumers is required, so sport fans are recruited. A pre-registered experiment (N = 600) tests the influence of a focused “team” benefiting message vs a broader “sport” benefiting message on change in illegal intentions. The influence of group (team) identity and trait reciprocity on message efficacy are tested as measures of group heuristics. Results suggest that the “team” treatment significantly reduces illegal consumption intentions. The “sport” treatment interacted with the team identification measure, increasing illegal consumption intentions for low team identification individuals. The results suggest that corporate social responsibility may be effective in reducing illegal consumption, if the messages are delivered directly from brands to consumers with brand identification. Messages delivered on the behalf of an industry may have an undesirable effect.

Keywords: live sports, piracy, counterfeiting, corporate social responsibility, group heuristics, ingroup bias, team identification

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495 Modeling Average Paths Traveled by Ferry Vessels Using AIS Data

Authors: Devin Simmons

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At the USDOT’s Bureau of Transportation Statistics, a biannual census of ferry operators in the U.S. is conducted, with results such as route mileage used to determine federal funding levels for operators. AIS data allows for the possibility of using GIS software and geographical methods to confirm operator-reported mileage for individual ferry routes. As part of the USDOT’s work on the ferry census, an algorithm was developed that uses AIS data for ferry vessels in conjunction with known ferry terminal locations to model the average route travelled for use as both a cartographic product and confirmation of operator-reported mileage. AIS data from each vessel is first analyzed to determine individual journeys based on the vessel’s velocity, and changes in velocity over time. These trips are then converted to geographic linestring objects. Using the terminal locations, the algorithm then determines whether the trip represented a known ferry route. Given a large enough dataset, routes will be represented by multiple trip linestrings, which are then filtered by DBSCAN spatial clustering to remove outliers. Finally, these remaining trips are ready to be averaged into one route. The algorithm interpolates the point on each trip linestring that represents the start point. From these start points, a centroid is calculated, and the first point of the average route is determined. Each trip is interpolated again to find the point that represents one percent of the journey’s completion, and the centroid of those points is used as the next point in the average route, and so on until 100 points have been calculated. Routes created using this algorithm have shown demonstrable improvement over previous methods, which included the implementation of a LOESS model. Additionally, the algorithm greatly reduces the amount of manual digitizing needed to visualize ferry activity.

Keywords: ferry vessels, transportation, modeling, AIS data

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494 Rural Development as a Strategy to Deter Migration in India - Re-Examining the Ideology of Cluster Development

Authors: Nandini Mohan, Thiruvengadam R. B.

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Mahatma Gandhi advocated that the true indicator of modern India lay in the development of its villages. This has been proven with the recent outbreak of the Coronavirus pandemic and the surfacing predicament of our urban centers. Developed on the Industrialization model, the current state of the metropolis is of rampant overcrowding, high rates of unemployment, inadequate infrastructure, and resources to cater to the growing population. A majority of each city’s strength composes of the migrant population, demonstrated through the migrant crisis, a direct repercussion of COVID-19. This paper explores the ideology of how rural development can act as a tactic to counter the high rates of rural-urban migration. It establishes the need for a rural push, as India is predominantly an agrarian economy, with a vast disparity between the urban and rural centers due to its urban bias. It seeks to define development in holistic terms. It studies the models of ‘cluster’ as conceptualized by V.K.R.V. Rao, and detailed by Architect Charles Correa in his book, The New Landscape. The paper reexamines the theory of cluster development through existing models proposed by the government of India. Namely, PURA (Provision of Urban Amenities in Rural Areas), DRI (Deendayal Research Institute), and Rurban under Shyama Prasad Mukharjee Rurban Mission. It analyses the models, their strengths, weaknesses, and reasons for their failure and success to derive parameters for the ideation of an archetype model. A model of rural development that talks of the simultaneous development of existing adjacent villages, by the introduction of set unique functions, that may turn into self-sustaining clusters or agglomerations in the future, which could serve as the next step for Indian village development based on the cluster ideology.

Keywords: counter migration, models of rural development, cluster development theory, India

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493 Maximum Likelihood Estimation Methods on a Two-Parameter Rayleigh Distribution under Progressive Type-Ii Censoring

Authors: Daniel Fundi Murithi

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Data from economic, social, clinical, and industrial studies are in some way incomplete or incorrect due to censoring. Such data may have adverse effects if used in the estimation problem. We propose the use of Maximum Likelihood Estimation (MLE) under a progressive type-II censoring scheme to remedy this problem. In particular, maximum likelihood estimates (MLEs) for the location (µ) and scale (λ) parameters of two Parameter Rayleigh distribution are realized under a progressive type-II censoring scheme using the Expectation-Maximization (EM) and the Newton-Raphson (NR) algorithms. These algorithms are used comparatively because they iteratively produce satisfactory results in the estimation problem. The progressively type-II censoring scheme is used because it allows the removal of test units before the termination of the experiment. Approximate asymptotic variances and confidence intervals for the location and scale parameters are derived/constructed. The efficiency of EM and the NR algorithms is compared given root mean squared error (RMSE), bias, and the coverage rate. The simulation study showed that in most sets of simulation cases, the estimates obtained using the Expectation-maximization algorithm had small biases, small variances, narrower/small confidence intervals width, and small root of mean squared error compared to those generated via the Newton-Raphson (NR) algorithm. Further, the analysis of a real-life data set (data from simple experimental trials) showed that the Expectation-Maximization (EM) algorithm performs better compared to Newton-Raphson (NR) algorithm in all simulation cases under the progressive type-II censoring scheme.

Keywords: expectation-maximization algorithm, maximum likelihood estimation, Newton-Raphson method, two-parameter Rayleigh distribution, progressive type-II censoring

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492 Predictors of Post-marketing Regulatory Actions Concerning Hepatotoxicity

Authors: Salwa M. Almomen, Mona A. Almaghrabi, Saja M. Alhabardi, Adel A. Alrwisan

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Background: Hepatotoxicity is a major reason for medication withdrawal from the markets. Unfortunately, serious adverse hepatic effects can occur after marketing with limited indicators during clinical development. Therefore, finding possible predictors for hepatotoxicity might guide the monitoring program of various stakeholders. Methods: We examined the clinical review documents for drugs approved in the US from 2011 to 2016 to evaluate their hepatic safety profile. Predictors: we assessed whether these medications meet Hy’s Law with hepatotoxicity grade ≥ 3, labeled hepatic adverse effects at approval, or accelerated approval status. Outcome: post-marketing regulatory action related to hepatotoxicity, including product withdrawal or updates to warning, precaution, or adverse effects sections. Statistical analysis: drugs were included in the analysis from the time of approval until the end of 2019 or the first post-marketing regulatory action related to hepatotoxicity, whichever occurred first. The hazard ratio (HR) was estimated using Cox-regression analysis. Results: We included 192 medications in the study. We classified 48 drugs as having grade ≥ 3 hepatotoxicities, 43 had accelerated approval status, and 74 had labeled information about hepatotoxicity prior to marketing. The adjusted HRs for post-marketing regulatory action for products with grade ≥ 3 hepatotoxicity was 0.61 (95% confidence interval [CI], 0.17-2.23), 0.92 (95%CI, 0.29-2.93) for a drug approved via accelerated approval program, and was 0.91 (95%CI, 0.33-2.56) for drugs with labeled hepatotoxicity information at approval time. Conclusion: This study does not provide conclusive evidence on the association between post-marketing regulatory action and grade ≥ 3 hepatotoxicity, accelerated approval status, or availability of labeled information at approval due to sampling size and channeling bias.

Keywords: accelerated approvals, hepatic adverse effects, drug-induced liver injury, hepatotoxicity predictors, post-marketing withdrawal

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491 Rapid Assessment the Ability of Forest Vegetation in Kulonprogo to Store Carbon Using Multispectral Satellite Imagery and Vegetation Index

Authors: Ima Rahmawati, Nur Hafizul Kalam

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Development of industrial and economic sectors in various countries very rapidly caused raising the greenhouse gas (GHG) emissions. Greenhouse gases are dominated by carbon dioxide (CO2) and methane (CH4) in the atmosphere that make the surface temperature of the earth always increase. The increasing gases caused by incomplete combustion of fossil fuels such as petroleum and coals and also high rate of deforestation. Yogyakarta Special Province which every year always become tourist destination, has a great potency in increasing of greenhouse gas emissions mainly from the incomplete combustion. One of effort to reduce the concentration of gases in the atmosphere is keeping and empowering the existing forests in the Province of Yogyakarta, especially forest in Kulonprogro is to be maintained the greenness so that it can absorb and store carbon maximally. Remote sensing technology can be used to determine the ability of forests to absorb carbon and it is connected to the density of vegetation. The purpose of this study is to determine the density of the biomass of forest vegetation and determine the ability of forests to store carbon through Photo-interpretation and Geographic Information System approach. Remote sensing imagery that used in this study is LANDSAT 8 OLI year 2015 recording. LANDSAT 8 OLI imagery has 30 meters spatial resolution for multispectral bands and it can give general overview the condition of the carbon stored from every density of existing vegetation. The method is the transformation of vegetation index combined with allometric calculation of field data then doing regression analysis. The results are model maps of density and capability level of forest vegetation in Kulonprogro, Yogyakarta in storing carbon.

Keywords: remote sensing, carbon, kulonprogo, forest vegetation, vegetation index

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490 Soil Degradati̇on Mapping Using Geographic Information System, Remote Sensing and Laboratory Analysis in the Oum Er Rbia High Basin, Middle Atlas, Morocco

Authors: Aafaf El Jazouli, Ahmed Barakat, Rida Khellouk

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Mapping of soil degradation is derived from field observations, laboratory measurements, and remote sensing data, integrated quantitative methods to map the spatial characteristics of soil properties at different spatial and temporal scales to provide up-to-date information on the field. Since soil salinity, texture and organic matter play a vital role in assessing topsoil characteristics and soil quality, remote sensing can be considered an effective method for studying these properties. The main objective of this research is to asses soil degradation by combining remote sensing data and laboratory analysis. In order to achieve this goal, the required study of soil samples was taken at 50 locations in the upper basin of Oum Er Rbia in the Middle Atlas in Morocco. These samples were dried, sieved to 2 mm and analyzed in the laboratory. Landsat 8 OLI imagery was analyzed using physical or empirical methods to derive soil properties. In addition, remote sensing can serve as a supporting data source. Deterministic potential (Spline and Inverse Distance weighting) and probabilistic interpolation methods (ordinary kriging and universal kriging) were used to produce maps of each grain size class and soil properties using GIS software. As a result, a correlation was found between soil texture and soil organic matter content. This approach developed in ongoing research will improve the prospects for the use of remote sensing data for mapping soil degradation in arid and semi-arid environments.

Keywords: Soil degradation, GIS, interpolation methods (spline, IDW, kriging), Landsat 8 OLI, Oum Er Rbia high basin

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489 Engaging With Sex, Gender and Sexuality Diversity at Higher Education Institutions

Authors: Shakila Singh

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Dominant discourses constitute heterosexuality as natural, normal and the only legitimate sexuality, and diverse sexual subjectivities as abnormal, unnatural and socially taboo. Similarly, the cisgender subject is reified. There are ongoing debates about the inclusion and suitability of sexuality education in the school curriculum and research show that teachers are not adequately prepared to teach about such issues in the classroom. Not surprising then, that many young people enter these institutions having had limited previous exposure to, or education about, sex, gender and sexuality diversity. This paper discusses the presence of heterosexism and cissexism at multiple layers in higher education institutions, impacting students and staff. Increasing knowledge and awareness of sex, gender and sexuality diversities is also crucial to challenging existing perceptions of sex, gender and sexuality diversities that marginalise and subordinate a large proportion of students and staff. There is a persistent disjuncture between dominant discourses that generally position higher education institutions as socially progressive, open environments and the discourses that legitimate the ascendency of heterosexual and cisgender identities. This paper argues that such disjuncture must be addressed by providing inclusive physical and emotional spaces if universities are to affirm every individual and produce graduates across all disciplines with the cultural capability to engage with increasingly diverse communities. Given the key role of language in shaping cultural and social attitudes, using gender-inclusive language is a powerful way to promote gender equality and eradicate gender bias. This means speaking and writing in a way that does not discriminate against a particular sex, gender or sexual identity and does not perpetuate gender stereotypes. Individuals must be allowed to present themselves and identify in ways they choose and be addressed by their chosen pronouns.

Keywords: heteronormativity, inclusivity, gender, universities

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488 Psychical Impacts of Episiotomy: First Results

Authors: Clesse C., Lighezzolo-Alnot J., De Lavergne S.

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Considered as the most common surgical procedure worldwide, episiotomy can be defined as an incision around the vulva performed to enlarge it, in the aim of preventing the traumatic rupture of the perineum during childbirth. Rather mediatized, this practice raises many questions in the field of mental health, relayed by different users and health professionals. Today, is topicality is moderately hectic since many queries about the prophylactic exercise of episiotomy are subject to a relative consensus, particularly since WHO advocated in 1996 that only 10% of childbirths should involve an episiotomy. This indicator appeared after the publication of numerous results from randomized clinical trials. Unfortunately, these papers seem mostly centered about somatic impacts of episiotomy. From the side of psychological studies, they mostly integrate a major clinical methodological bias, especially considering that every primiparous woman is identical to the others face to the experience of parturition. In the aim to fill this lack of knowledge, we developed a longitudinal research starting in the 7th month of pregnancy and ending one year after delivery. We are studying in a comparative way different possible psychological consequences inherent to the use of episiotomy. To do this, we use a standardized methodology which combines semi-structured clinical interviews (IRMAG, IRMAN ...), free clinical interviews, a projective test (Rorschach) and five questionnaires (QIC, EPDS, CPQ WOMBLSQ4, SF36). Therefore, we can comprehend with shrewdness the question of psychic impacts of episiotomy in a qualitative and quantitative way by comparing it to other obstetric interventions. In this paper, we will present the first results obtained about a population of twenty-two primiparous women by focusing on body image, sexuality, quality of life, depressive affects, post-traumatic stress disorder and investment of the maternal role. Finally, we will consider the different implications and perspectives of this research which could improve the public health policies in the field of perinatal care.

Keywords: assessment, episiotomy, mental health, psychical impacts

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487 Monitoring the Change of Padma River Bank at Faridpur, Bangladesh Using Remote Sensing Approach

Authors: Ilme Faridatul, Bo Wu

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Bangladesh is often called as a motherland of rivers. It contains about 700 rivers among all these the Padma River is one of the largest rivers of Bangladesh. The change of river bank and erosion has become a common environmental natural hazard in Bangladesh. The river banks are under intense pressure from natural processes such as erosion and accretion as well as anthropogenic processes such as urban growth and pollution. The Padma River is flowing along ten districts of Bangladesh among all these Faridpur district is most vulnerable to river bank erosion. The severity of the river erosion is so high that each year a thousand of populations become homeless and lose their agricultural lands. Though the Faridpur district is most vulnerable to river bank erosion no specific research has been conducted to identify the changing pattern of river bank along this district. The outcome of the research may serve as guidance to prepare river bank monitoring program and management. This research has utilized integrated techniques of remote sensing and geographic information system to monitor the changes from 1995 to 2015 at Faridpur district. To discriminate the land water interface Modified Normalized Difference Water Index (MNDWI) algorithm is applied and on screen digitization approach is used over MNDWI images of 1995, 2002 and 2015 for river bank line extraction. The extent of changes in the river bank along Faridpur district is estimated through overlaying the digitized maps of all three years. The river bank lines are highlighted to infer the erosion and accretion and the changes are calculated. The result shows that the middle of the river is gaining land through sedimentation and the both side river bank is shifting causing severe erosion that consequently resulting the loss of farmland and homestead. Over the study period from 1995 to 2015 it witnessed huge erosion and accretion that played an active role in the changes of the river bank.

Keywords: river bank, erosion and accretion, change monitoring, remote sensing

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486 The Inherent Flaw in the NBA Playoff Structure

Authors: Larry Turkish

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Introduction: The NBA is an example of mediocrity and this will be evident in the following paper. The study examines and evaluates the characteristics of the NBA champions. As divisions and playoff teams increase, there is an increase in the probability that the champion originates from the mediocre category. Since it’s inception in 1947, the league has been mediocre and continues to this day. Why does a professional league allow any team with a less than 50% winning percentage into the playoffs? As long as the finances flow into the league, owners will not change the current algorithm. The objective of this paper is to determine if the regular season has meaning in finding an NBA champion. Statistical Analysis: The data originates from the NBA website. The following variables are part of the statistical analysis: Rank, the rank of a team relative to other teams in the league based on the regular season win-loss record; Winning Percentage of a team based on the regular season; Divisions, the number of divisions within the league and Playoff Teams, the number of playoff teams relative to a particular season. The following statistical applications are applied to the data: Pearson Product-Moment Correlation, Analysis of Variance, Factor and Regression analysis. Conclusion: The results indicate that the divisional structure and number of playoff teams results in a negative effect on the winning percentage of playoff teams. It also prevents teams with higher winning percentages from accessing the playoffs. Recommendations: 1. Teams that have a winning percentage greater than 1 standard deviation from the mean from the regular season will have access to playoffs. (Eliminates mediocre teams.) 2. Eliminate Divisions (Eliminates weaker teams from access to playoffs.) 3. Eliminate Conferences (Eliminates weaker teams from access to the playoffs.) 4. Have a balanced regular season schedule, (Reduces the number of regular season games, creates equilibrium, reduces bias) that will reduce the need for load management.

Keywords: alignment, mediocrity, regression, z-score

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485 Advancing Spatial Mapping and Monitoring of Illegal Landfills for Deprived Urban Areas in Romania

Authors: ȘercăIanu Mihai, Aldea Mihaela, Iacoboaea Cristina, Luca Oana, Nenciu Ioana

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The emergence and neutralization of illegal waste dumps represent a global concern for waste management ecosystems with a particularly pronounced impact on disadvantaged communities. All over the world, and in this particular case in Romania, a relevant number of people resided in houses lacking any legal forms such as land ownership documents or building permits. These areas are referred to as “informal settlements”. An increasing number of regions and cities in Romania are struggling to manage their waste dumps, especially in the context of increasing poverty and lack of regulation related to informal settlements. An example of such informal settlement can be found at the terminus of Bistra Street in Câlnic, which falls under the jurisdiction of the Municipality of Reșița in Caras Severin County. The article presents a case study that focuses on employing remote sensing techniques and spatial data to monitor and map illegal waste practices, with subsequent integration into a geographic information system tailored for the Reșița community. In addition, the paper outlines the steps involved in devising strategies aimed at enhancing waste management practices in disadvantaged areas, aligning with the shift toward a circular economy. Results presented in the paper contain a spatial mapping and visualization methodology calibrated with in situ data collection applicable for identifying illegal landfills. The emergence and neutralization of illegal dumps pose a challenge in the field of waste management. These approaches, which prove effective where conventional solutions have failed, need to be replicated and adopted more wisely.

Keywords: waste dumps, waste management, monitoring, GIS, informal settlements

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484 Exploring the Growth Path under Coupling Relationship between Space and Economy of Mountain Village and Townlets: Case Study of Southwest China

Authors: Runlin Liu, Shilong Li

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China is a mountainous country, with two-thirds of its territory covered by plateaus, hills, and mountains, and nearly half of the cities and towns are distributed in mountainous areas. Compared with the environmental constraints in the development path of cities and towns in the plains, there are heterogeneities in aspects such as spatial characteristics, growth mode, and ecological protection and so on for mountain village and townlets, and the development path of mountain village and townlets has a bidirectional relationship between mountain space and economic growth. Based on classical growth theory, this article explores the two-dimensional coupling relation between space and economy in mountain village and townlets under background of rural rejuvenation. GIS technology is adopted in the study to analyze spatial trends and patterns, economical spatial differentiation characteristics of village and townlets. This powerful tool can also help differentiate and analyze limiting factors and assessment systems in the economic growth of village and townlets under spatial dimension of mountainous space. To make the research more specific, this article selects mountain village and townlets in Southwest China as the object of study; this provides good cases for analyzing parallel coupling mechanism of the duality structure system between economic growth and spatial expansion and discussing the path selection of spatial economic growth of mountain village and towns with multiple constraints. The research results can provide quantitative references for the spatial and economic development paths of mountain villages and towns, which is helpful in realizing efficient and high-quality development mode with equal emphasis on spatial and economic benefits for these type of towns.

Keywords: coupling mechanism, geographic information technology, mountainous town, synergetic development, spatial economy

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483 Study of the Hydrochemical Composition of Canal, Collector-Drainage and Ground Waters of Kura-Araz Plain and Modeling by GIS Method

Authors: Gurbanova Lamiya

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The Republic of Azerbaijan is considered a region with limited water resources, as up to 70% of surface water is formed outside the country's borders, and most of its territory is an arid (dry) climate zone. It is located at the lower limit of transboundary flows, which is the weakest source of natural water resources in the South Caucasus. It is essential to correctly assess the quality of natural, collector-drainage and groundwater of the area and their suitability for irrigation in order to properly carry out land reclamation measures, provide the normal water-salt regime, and prevent repeated salinization. Through the 141-km-long main Mil-Mugan collector, groundwater, household waste, and floodwaters generated during floods and landslides are poured into the Caspian Sea. The hydrochemical composition of the samples taken from the Sabir irrigation canal passing through the center of the Kura-Araz plain, the Main Mil-Mugan Collector, and the groundwater of the region, which we chose as our research object, were studied and the obtained results were compared by periods. A model is proposed that allows for a complete visualization of the primary materials collected for the study area. The practical use of the established digital model provides all possibilities. The practical use of the established digital model provides all possibilities. An extensive database was created with the ArcGis 10.8 package, using publicly available LandSat satellite images as primary data in addition to ground surveys to build the model. The principles of the construction of the geographic information system of modern GIS technology were developed, the boundary and initial condition of the research area were evaluated, and forecasts and recommendations were given.

Keywords: irrigation channel, groundwater, collector, meliorative measures

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482 Flood Mapping and Inoudation on Weira River Watershed (in the Case of Hadiya Zone, Shashogo Woreda)

Authors: Alilu Getahun Sulito

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Exceptional floods are now prevalent in many places in Ethiopia, resulting in a large number of human deaths and property destruction. Lake Boyo watershed, in particular, had also traditionally been vulnerable to flash floods throughout the Boyo watershed. The goal of this research is to create flood and inundation maps for the Boyo Catchment. The integration of Geographic information system(GIS) technology and the hydraulic model (HEC-RAS) were utilized as methods to attain the objective. The peak discharge was determined using Fuller empirical methodology for intervals of 5, 10, 15, and 25 years, and the results were 103.2 m3/s, 158 m3/s, 222 m3/s, and 252 m3/s, respectively. River geometry, boundary conditions, manning's n value of varying land cover, and peak discharge at various return periods were all entered into HEC-RAS, and then an unsteady flow study was performed. The results of the unsteady flow study demonstrate that the water surface elevation in the longitudinal profile rises as the different periods increase. The flood inundation charts clearly show that regions on the right and left sides of the river with the greatest flood coverage were 15.418 km2 and 5.29 km2, respectively, flooded by 10,20,30, and 50 years. High water depths typically occur along the main channel and progressively spread to the floodplains. The latest study also found that flood-prone areas were disproportionately affected on the river's right bank. As a result, combining GIS with hydraulic modelling to create a flood inundation map is a viable solution. The findings of this study can be used to care again for the right bank of a Boyo River catchment near the Boyo Lake kebeles, according to the conclusion. Furthermore, it is critical to promote an early warning system in the kebeles so that people can be evacuated before a flood calamity happens. Keywords: Flood, Weira River, Boyo, GIS, HEC- GEORAS, HEC- RAS, Inundation Mapping

Keywords: Weira River, Boyo, GIS, HEC- GEORAS, HEC- RAS, Inundation Mapping

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481 Waters Colloidal Phase Extraction and Preconcentration: Method Comparison

Authors: Emmanuelle Maria, Pierre Crançon, Gaëtane Lespes

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Colloids are ubiquitous in the environment and are known to play a major role in enhancing the transport of trace elements, thus being an important vector for contaminants dispersion. Colloids study and characterization are necessary to improve our understanding of the fate of pollutants in the environment. However, in stream water and groundwater, colloids are often very poorly concentrated. It is therefore necessary to pre-concentrate colloids in order to get enough material for analysis, while preserving their initial structure. Many techniques are used to extract and/or pre-concentrate the colloidal phase from bulk aqueous phase, but yet there is neither reference method nor estimation of the impact of these different techniques on the colloids structure, as well as the bias introduced by the separation method. In the present work, we have tested and compared several methods of colloidal phase extraction/pre-concentration, and their impact on colloids properties, particularly their size distribution and their elementary composition. Ultrafiltration methods (frontal, tangential and centrifugal) have been considered since they are widely used for the extraction of colloids in natural waters. To compare these methods, a ‘synthetic groundwater’ was used as a reference. The size distribution (obtained by Field-Flow Fractionation (FFF)) and the chemical composition of the colloidal phase (obtained by Inductively Coupled Plasma Mass Spectrometry (ICPMS) and Total Organic Carbon analysis (TOC)) were chosen as comparison factors. In this way, it is possible to estimate the pre-concentration impact on the colloidal phase preservation. It appears that some of these methods preserve in a more efficient manner the colloidal phase composition while others are easier/faster to use. The choice of the extraction/pre-concentration method is therefore a compromise between efficiency (including speed and ease of use) and impact on the structural and chemical composition of the colloidal phase. In perspective, the use of these methods should enhance the consideration of colloidal phase in the transport of pollutants in environmental assessment studies and forensics.

Keywords: chemical composition, colloids, extraction, preconcentration methods, size distribution

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480 Compliance of Systematic Reviews in Ophthalmology with the PRISMA Statement

Authors: Seon-Young Lee, Harkiran Sagoo, Reem Farwana, Katharine Whitehurst, Alex Fowler, Riaz Agha

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Background/Aims: Systematic reviews and meta-analysis are becoming increasingly important way of summarizing research evidence. Researches in ophthalmology may represent further challenges, due to their potential complexity in study design. The aim of our study was to determine the reporting quality of systematic reviews and meta-analysis in ophthalmology with the PRISMA statement, by assessing the articles published between 2010 and 2015 from five major journals with the highest impact factor. Methods: MEDLINE and EMBASE were used to search systematic reviews published between January 2010 and December 2015, in 5 major ophthalmology journals: Progress in Retinal and Eye Research, Ophthalmology, Archives of Ophthalmology, American Journal of Ophthalmology, Journal of the American Optometric Association. Screening, identification, and scoring of articles were performed independently by two teams, followed by statistical analysis including the median, range, and 95% CIs. Results: 115 articles were involved. The median PRISMA score was 15 of 27 items (56%), with a range of 5-26 (19-96%) and 95% CI 13.9-16.1 (51-60%). Compliance was highest in items related to the description of rationale (item 3,100%) and inclusion of a structured summary in the abstract (item 2, 90%), while poorest in indication of review protocol and registration (item 5, 9%), specification of risk of bias affecting the cumulative evidence (item 15, 24%) and description of clear objectives in introduction (item 4, 26%). Conclusion: The reporting quality of systematic reviews and meta-analysis in ophthalmology need significant improvement. While the use of PRISMA criteria as a guideline before journal submission is recommended, additional research identifying potential barriers may be required to improve the compliance to the PRISMA guidelines.

Keywords: systematic reviews, meta-analysis, research methodology, reporting quality, PRISMA, ophthalmology

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479 Decision Making in Medicine and Treatment Strategies

Authors: Kamran Yazdanbakhsh, Somayeh Mahmoudi

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Three reasons make good use of the decision theory in medicine: 1. Increased medical knowledge and their complexity makes it difficult treatment information effectively without resorting to sophisticated analytical methods, especially when it comes to detecting errors and identify opportunities for treatment from databases of large size. 2. There is a wide geographic variability of medical practice. In a context where medical costs are, at least in part, by the patient, these changes raise doubts about the relevance of the choices made by physicians. These differences are generally attributed to differences in estimates of probabilities of success of treatment involved, and differing assessments of the results on success or failure. Without explicit criteria for decision, it is difficult to identify precisely the sources of these variations in treatment. 3. Beyond the principle of informed consent, patients need to be involved in decision-making. For this, the decision process should be explained and broken down. A decision problem is to select the best option among a set of choices. The problem is what is meant by "best option ", or know what criteria guide the choice. The purpose of decision theory is to answer this question. The systematic use of decision models allows us to better understand the differences in medical practices, and facilitates the search for consensus. About this, there are three types of situations: situations certain, risky situations, and uncertain situations: 1. In certain situations, the consequence of each decision are certain. 2. In risky situations, every decision can have several consequences, the probability of each of these consequences is known. 3. In uncertain situations, each decision can have several consequences, the probability is not known. Our aim in this article is to show how decision theory can usefully be mobilized to meet the needs of physicians. The decision theory can make decisions more transparent: first, by clarifying the data systematically considered the problem and secondly by asking a few basic principles should guide the choice. Once the problem and clarified the decision theory provides operational tools to represent the available information and determine patient preferences, and thus assist the patient and doctor in their choices.

Keywords: decision making, medicine, treatment strategies, patient

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478 Conservation Planning of Paris Polyphylla Smith, an Important Medicinal Herb of the Indian Himalayan Region Using Predictive Distribution Modelling

Authors: Mohd Tariq, Shyamal K. Nandi, Indra D. Bhatt

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Paris polyphylla Smith (Family- Liliaceae; English name-Love apple: Local name- Satuwa) is an important folk medicinal herb of the Indian subcontinent, being a source of number of bioactive compounds for drug formulation. The rhizomes are widely used as antihelmintic, antispasmodic, digestive stomachic, expectorant and vermifuge, antimicrobial, anti-inflammatory, heart and vascular malady, anti-fertility and sedative. Keeping in view of this, the species is being constantly removed from nature for trade and various pharmaceuticals purpose, as a result, the availability of the species in its natural habitat is decreasing. In this context, it would be pertinent to conserve this species and reintroduce them in its natural habitat. Predictive distribution modelling of this species was performed in Western Himalayan Region. One such recent method is Ecological Niche Modelling, also popularly known as Species distribution modelling, which uses computer algorithms to generate predictive maps of species distributions in a geographic space by correlating the point distributional data with a set of environmental raster data. In case of P. polyphylla, and to understand its potential distribution zones and setting up of artificial introductions, or selecting conservation sites, and conservation and management of their native habitat. Among the different districts of Uttarakhand (28°05ˈ-31°25ˈ N and 77°45ˈ-81°45ˈ E) Uttarkashi, Rudraprayag, Chamoli, Pauri Garhwal and some parts of Bageshwar, 'Maximum Entropy' (Maxent) has predicted wider potential distribution of P. polyphylla Smith. Distribution of P. polyphylla is mainly governed by Precipitation of Driest Quarter and Mean Diurnal Range i.e., 27.08% and 18.99% respectively which indicates that humidity (27%) and average temperature (19°C) might be suitable for better growth of Paris polyphylla.

Keywords: biodiversity conservation, Indian Himalayan region, Paris polyphylla, predictive distribution modelling

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477 Gender Bias in Natural Language Processing: Machines Reflect Misogyny in Society

Authors: Irene Yi

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Machine learning, natural language processing, and neural network models of language are becoming more and more prevalent in the fields of technology and linguistics today. Training data for machines are at best, large corpora of human literature and at worst, a reflection of the ugliness in society. Machines have been trained on millions of human books, only to find that in the course of human history, derogatory and sexist adjectives are used significantly more frequently when describing females in history and literature than when describing males. This is extremely problematic, both as training data, and as the outcome of natural language processing. As machines start to handle more responsibilities, it is crucial to ensure that they do not take with them historical sexist and misogynistic notions. This paper gathers data and algorithms from neural network models of language having to deal with syntax, semantics, sociolinguistics, and text classification. Results are significant in showing the existing intentional and unintentional misogynistic notions used to train machines, as well as in developing better technologies that take into account the semantics and syntax of text to be more mindful and reflect gender equality. Further, this paper deals with the idea of non-binary gender pronouns and how machines can process these pronouns correctly, given its semantic and syntactic context. This paper also delves into the implications of gendered grammar and its effect, cross-linguistically, on natural language processing. Languages such as French or Spanish not only have rigid gendered grammar rules, but also historically patriarchal societies. The progression of society comes hand in hand with not only its language, but how machines process those natural languages. These ideas are all extremely vital to the development of natural language models in technology, and they must be taken into account immediately.

Keywords: gendered grammar, misogynistic language, natural language processing, neural networks

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476 Geographic Information System Application for Predicting Tourism Development in Gunungkidul Regency, Indonesia

Authors: Nindyo Cahyo Kresnanto, Muhamad Willdan, Wika Harisa Putri

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Gunungkidul is one of the emerging tourism industry areas in Yogyakarta Province, Indonesia. This article describes how GIS can predict the development of tourism potential in Gunungkidul. The tourism sector in Gunungkidul Regency contributes 3.34% of the total gross regional domestic product and is the economic sector with the highest growth with a percentage of 18.37% in the post-Covid-19 period. This contribution makes researchers consider that several tourist sites need to be explored more to increase regional economic development gradually. This research starts by collecting spatial data from tourist locations tourists want to visit in Gunungkidul Regency based on survey data from 571 respondents. Then the data is visualized with ArcGIS software. This research shows an overview of tourist destinations interested in travellers depicted from the lowest to the highest from the data visualization. Based on the data visualization results, specific tourist locations potentially developed to influence the surrounding economy positively. The visualization of the data displayed is also in the form of a desire line map that shows tourist travel patterns from the origin of the tourist to the destination of the tourist location of interest. From the desire line, the prediction of the path of tourist sites with a high frequency of transportation activity can figure out. Predictions regarding specific tourist location routes that high transportation activities can burden can consider which routes will be chosen. The route also needs to be improved in terms of capacity and quality. The goal is to provide a sense of security and comfort for tourists who drive and positively impact the tourist sites traversed by the route.

Keywords: tourism development, GIS and survey, transportation, potential desire line

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475 Gender Stereotypes in Reproductive Medicine with Regard to Parental Age

Authors: Monika Michałowska, Anna Alichniewicz

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Detrimental outcomes of advanced maternal age on the chances of fertilization, pregnancy as well as mother and fetus health have been recognized for several decades. It seemed interesting to investigate whether there is a comparable awareness of the detrimental influence on the reproductive outcomes of late fatherhood, given that it has been already ten years since an intense and growing interest concerning later-age fatherhood commenced in medical research. To address that issue a two-step research was done. First, we performed a review of the subject literature to answer the following questions: 1) What age is defined as advanced?; 2) Is the same age defined as advanced in both genders?; 3) What terminology concerning age issues is used?; 4) Is the same age terminology used regarding both genders? The second part of our studies was devoted to the views of medical students. This part of our research comprised both quantitative and qualitative studies. Opinions of medical students in one of the Polish medical universities on several issues connected with assisted reproduction technology (ART) were gathered: 1) students’ attitude to in vitro fertilization (IVF) for women over 40 and for postmenopausal women; 2) students’ attitude to late fatherhood; 3) students’ reasoning given against acceptability of IVF procedure for all of these group of patients involved in an IVF procedure. Our analyses revealed that: First, there is no universal definition of the term ‘advanced age’; secondly, there is a general tendency to adopt different age limits depending on whether they refer to maternal or paternal age, but no justification is provided by the researchers explaining why they set different age limits for women and men; thirdly, the image of postponed fatherhood stands in stark contrast to postponed motherhood - while postponed fatherhood is frequently portrayed as a reasonable and conscious decision enabling a stable family environment for a child, the reasonableness of postponed motherhood is often questioned; finally, the bias regarding maternal versus paternal age is deeply embedded in medical students’ attitude to IVF for women over 40 and for postmenopausal women.

Keywords: gender stereotypes, reproductive medicine, maternal age, paternal age

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