Search results for: nonparametric geographically weighted regression
Commenced in January 2007
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Edition: International
Paper Count: 3907

Search results for: nonparametric geographically weighted regression

2917 Adaptive E-Learning System Using Fuzzy Logic and Concept Map

Authors: Mesfer Al Duhayyim, Paul Newbury

Abstract:

This paper proposes an effective adaptive e-learning system that uses a coloured concept map to show the learner's knowledge level for each concept in the chosen subject area. A Fuzzy logic system is used to evaluate the learner's knowledge level for each concept in the domain, and produce a ranked concept list of learning materials to address weaknesses in the learner’s understanding. This system obtains information on the learner's understanding of concepts by an initial pre-test before the system is used for learning and a post-test after using the learning system. A Fuzzy logic system is used to produce a weighted concept map during the learning process. The aim of this research is to prove that such a proposed novel adapted e-learning system will enhance learner's performance and understanding. In addition, this research aims to increase participants' overall understanding of their learning level by providing a coloured concept map of understanding followed by a ranked concepts list of learning materials.

Keywords: adaptive e-learning system, coloured concept map, fuzzy logic, ranked concept list

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2916 Improved Approach to the Treatment of Resistant Breast Cancer

Authors: Lola T. Alimkhodjaeva, Lola T. Zakirova, Soniya S. Ziyavidenova

Abstract:

Background: Breast cancer (BC) is still one of the urgent oncology problems. The essential obstacle to the full anti-tumor therapy implementation is drug resistance development. Taking into account the fact that chemotherapy is main antitumor treatment in BC patients, the important task is to improve treatment results. Certain success in overcoming this situation has been associated with the use of methods of extracorporeal blood treatment (ECBT), plasmapheresis. Materials and Methods: We examined 129 women with resistant BC stages 3-4, aged between 56 to 62 years who had previously received 2 courses of CAF chemotherapy. All patients additionally underwent 2 courses of CAF chemotherapy but against the background ECBT with ultrasonic exposure. We studied the following parameters: 1. The highlights of peripheral blood before and after therapy. 2. The state of cellular immunity and identification of activation markers CD23 +, CD25 +, CD38 +, CD95 + on lymphocytes was performed using monoclonal antibodies. Evaluation of humoral immunity was determined by the level of main classes of immunoglobulins IgG, IgA, IgM in serum. 3. The degree of tumor regression was assessed by WHO recommended 4 gradations. (complete - 100%, partial - more than 50% of initial size, process stabilization–regression is less than 50% of initial size and tumor advance progressing). 4. Medical pathomorphism in the tumor was determined by Lavnikova. 5. The study of immediate and remote results, up to 3 years and more. Results and Discussion: After performing extracorporeal blood treatment anemia occurred in 38.9%, leukopenia in 36.8%, thrombocytopenia in 34.6%, hypolymphemia in 26.8%. Studies of immunoglobulin fractions in blood serum were able to establish a certain relationship between the classes of immunoglobulin A, G, M and their functions. The results showed that after treatment the values of main immunoglobulins in patients’ serum approximated to normal. Analysis of expression of activation markers CD25 + cells bearing receptors for IL-2 (IL-2Rα chain) and CD95 + lymphocytes that were mediated physiological apoptosis showed the tendency to increase, which apparently was due to activation of cellular immunity cytokines allocated by ultrasonic treatment. To carry out ECBT on the background of ultrasonic treatment improved the parameters of the immune system, which were expressed in stimulation of cellular immunity and correcting imbalances in humoral immunity. The key indicator of conducted treatment efficiency is the immediate result measured by the degree of tumor regression. After ECBT performance the complete regression was 10.3%, partial response - 55.5%, process stabilization - 34.5%, tumor advance progressing no observed. Morphological investigations of tumor determined therapeutic pathomorphism grade 2 in 15%, in 25% - grade 3 and therapeutic pathomorphism grade 4 in 60% of patients. One of the main criteria for the effect of conducted treatment is to study the remission terms in the postoperative period (up to 3 years or more). The remission terms up to 3 years with ECBT was 34.5%, 5-year survival was 54%. Carried out research suggests that a comprehensive study of immunological and clinical course of breast cancer allows the differentiated approach to the choice of methods for effective treatment.

Keywords: breast cancer, immunoglobulins, extracorporeal blood treatment, chemotherapy

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2915 Numerical Simulation of Convective Flow of Nanofluids with an Oriented Magnetic Field in a Half Circular-Annulus

Authors: M. J. Uddin, M. M. Rahman

Abstract:

The unsteady convective heat transfer flow of nanofluids in a half circular-annulus shape enclosure using nonhomogeneous dynamic model has been investigated numerically. The round upper wall of the enclosure is maintained at constant low temperature whereas the bottom wall is heated by three different thermal conditions. The enclosure is permeated by a uniform magnetic field having variable orientation. The Brownian motion and thermophoretic phenomena of the nanoparticles are taken into account in model construction. The governing nonlinear momentum, energy, and concentration equations are solved numerically using Galerkin weighted residual finite element method. To discover the best performer, the average Nusselt number is demonstrated for different types of nanofluids. The heat transfer rate for different flow parameters, positions of the annulus, thicknesses of the half circular-annulus and thermal conditions is also exhibited.

Keywords: nanofluid, convection, semicircular-annulus, nonhomogeneous dynamic model, finite element method

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2914 Development of IDF Curves for Precipitation in Western Watershed of Guwahati, Assam

Authors: Rajarshi Sharma, Rashidul Alam, Visavino Seleyi, Yuvila Sangtam

Abstract:

The Intensity-Duration-Frequency (IDF) relationship of rainfall amounts is one of the most commonly used tools in water resources engineering for planning, design and operation of water resources project, or for various engineering projects against design floods. The establishment of such relationships was reported as early as in 1932 (Bernard). Since then many sets of relationships have been constructed for several parts of the globe. The objective of this research is to derive IDF relationship of rainfall for western watershed of Guwahati, Assam. These relationships are useful in the design of urban drainage works, e.g. storm sewers, culverts and other hydraulic structures. In the study, rainfall depth for 10 years viz. 2001 to 2010 has been collected from the Regional Meteorological Centre Borjhar, Guwahati. Firstly, the data has been used to construct the mass curve for duration of more than 7 hours rainfall to calculate the maximum intensity and to form the intensity duration curves. Gumbel’s frequency analysis technique has been used to calculate the probable maximum rainfall intensities for a period of 2 yr, 5 yr, 10 yr, 50 yr, 100 yr from the maximum intensity. Finally, regression analysis has been used to develop the intensity-duration-frequency (IDF) curve. Thus, from the analysis the values for the constants ‘a’,‘b’ &‘c’ have been found out. The values of ‘a’ for which the sum of the squared deviation is minimum has been found out to be 40 and when the corresponding value of ‘c’ and ‘b’ for the minimum squared deviation of ‘a’ are 0.744 and 1981.527 respectively. The results obtained showed that in all the cases the correlation coefficient is very high indicating the goodness of fit of the formulae to estimate IDF curves in the region of interest.

Keywords: intensity-duration-frequency relationship, mass curve, regression analysis, correlation coefficient

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2913 A Prospective Study on the Efficacy of Mesenchymal Stem Cells in Intervertebral Disc Regeneration

Authors: Prabhu Thangaraju, Manoj Deepak, A. Sivakumar

Abstract:

Removal of inter vertebral disc along with spinal fusion has many disadvantages such as causing stress fractures. If it is possible regenerate the spine it would be possible avoid the complications of the surgery and achieve better results. Our study involves the use of mesenchymal stem cells in regenerating the discs. Our study involved 10 patients who presented with degenerative disc disease between 2008-2011 in our hospital. After adequate pre-operative check prepared mesenchymal stem cells were injected into the disc spaces. These patients were subjected to conservative therapy for a minimum of six weeks before they were accepted into the study. They were followed up regularly for a minimum of 2years with serial radiographs and MRI. 8 out of the 10 patients had completed reduction in the pain. The T2 weighted MRI images in 9 out of the 10 patients showed a bright signal compared the previous Images which indicated that there was improvement in the hydration levels. From the case study of 10 patients who were subjected to mesenchymal cell therapy in our hospital, we can conclude that the use of mesenchymal cells in treatment of intervertebral disc degeneration in a safe and effective option.

Keywords: mesenchymal stem cells, intervertebral disc, the spine, disc degeneration

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2912 Named Entity Recognition System for Tigrinya Language

Authors: Sham Kidane, Fitsum Gaim, Ibrahim Abdella, Sirak Asmerom, Yoel Ghebrihiwot, Simon Mulugeta, Natnael Ambassager

Abstract:

The lack of annotated datasets is a bottleneck to the progress of NLP in low-resourced languages. The work presented here consists of large-scale annotated datasets and models for the named entity recognition (NER) system for the Tigrinya language. Our manually constructed corpus comprises over 340K words tagged for NER, with over 118K of the tokens also having parts-of-speech (POS) tags, annotated with 12 distinct classes of entities, represented using several types of tagging schemes. We conducted extensive experiments covering convolutional neural networks and transformer models; the highest performance achieved is 88.8% weighted F1-score. These results are especially noteworthy given the unique challenges posed by Tigrinya’s distinct grammatical structure and complex word morphologies. The system can be an essential building block for the advancement of NLP systems in Tigrinya and other related low-resourced languages and serve as a bridge for cross-referencing against higher-resourced languages.

Keywords: Tigrinya NER corpus, TiBERT, TiRoBERTa, BiLSTM-CRF

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2911 The Potential of Southern Malang as Geotourism Site: The Distribution of Geodiversity and Geotrek in Southern Malang, Indonesia

Authors: Arda Bagus M, Yehezkiel Festian P, Budianto Santoso

Abstract:

The Tourism Area of Southern Malang is administratively located in the Regency of Malang, East Java Province, Indonesia and geographically is in a position between 112o17' - 112o57' E dan 7o44' - 8o26' S. Southern Malang consists of several sub-districts that directly borders with the Indian Ocean, such as Donomulyo, Bantur, Gedangan, Sumbermanjing, Tirto Yudo, and Ampel Gading. This area has a high geotourism potential because of the existence of geodiversity such as beaches, waterfalls, caves, and karst area. However, to the best of the authors’ knowledge, there is still no systematic data that informs the geotourism potentials to the public. The aim of this research is to complete the lack of data and then arrange it systematically so it can be used for both tourism and research purposes. Research methods such as field observation, literature study, and depth interview to local people have been implemented. Aspects reviewed by visiting the field are accommodation, transportation, and the feasibility of a place to be geotourism object. The primary data was taken in Sumbermanjing, Gedangan, Bantur, and Donomulyo sub-district. A literature study is needed to determine the regional geology of Southern Malang and as a comparison to new data obtained in the field. The results of the literature study show that southern Malang consists of three formations: Wonosari Formation, Mandalaka Formation, and River-swamps Sediment Formation with the age range of Oligocene to Quaternary. Depth interviews have been conducted by involving local people with the aim of knowing cultural-history in the research area. From this research, the geotourism object distribution map has been made. The map also includes Geotrek and basic geological information of each object. The results of this research can support the development of geotourism in Southern Malang.

Keywords: geodiversity, geology, geotourism, geotrek, southern Malang

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2910 Personal Characteristics and Personality Traits as Predictors of Compassion Fatigue among Counselors from Dominican Schools in the Philippines

Authors: Neil Jordan M. Uy, Fe Pelilia V. Hernandez

Abstract:

A counselor is always regarded as a professional who embodies the willingness to help others through the process of counseling. He is knowledgeable and skillful of the different theories, tools, and techniques that are useful in aiding the client to cope with their dilemmas. The negative experiences of the clients that are shared during the counseling session can affect the professional counselor. Compassion fatigue, a professional impairment, is characterized by the decline of one’s productivity and the feeling of anxiety and stress brought about as the counselor empathizes, listens, and cares for others. This descriptive type of research aimed to explore variables that are predictors of compassion fatigue utilizing three research instruments; Demographic Profile Sheet, Professional Quality of Life Scale, and Neo-Pi-R. The 52 respondents of this study were counselors from the different Dominican schools in the Philippines. Generally, the counselors have low level of compassion fatigue across personal characteristics (age, gender, years of service, highest educational attainment, and professional status) and personality traits (extraversion, agreeableness, conscientiousness, openness, and neuroticism). ANOVA validated the findings of this that among the personal characteristics and personality traits, extraversion with f-value of 3.944 and p-value of 0.026, and conscientiousness, with f-value of 4.125 and p-value of 0.022 were found to have significant difference in the level of compassion fatigue. A very significant difference was observed with neuroticism with f-value of 6.878 and p-value 0.002. Among the personal characteristics and personal characteristics, only neuroticism was found to predict compassion fatigue. The computed r2 value of 0.204 using multiple regression analysis suggests that 20.4 percent of compassion fatigue can be predicted by neuroticism. The predicting power of neuroticism can be computed from the regression model Y=0.156x+26.464; where x is the number of neuroticism.

Keywords: big five personality traits, compassion fatigue, counselors, professional quality of life scale

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2909 Evaluation of Environmental Disclosures on Financial Performance of Quoted Industrial Goods Manufacturing Sectors in Nigeria (2011 – 2020)

Authors: C. C. Chima, C. J. M. Anumaka

Abstract:

This study evaluates environmental disclosures on the financial performance of quoted industrial goods manufacturing sectors in Nigeria. The study employed a quasi-experimental research design to establish the relationship that exists between the environmental disclosure index and financial performance indices (return on assets - ROA, return on equity - ROE, and earnings per share - EPS). A purposeful sampling technique was employed to select five (5) industrial goods manufacturing sectors quoted on the Nigerian Stock Exchange. Secondary data covering 2011 to 2020 financial years were extracted from annual reports of the study sectors using a content analysis method. The data were analyzed using SPSS, Version 23. Panel Ordinary Least Squares (OLS) regression method was employed in estimating the unknown parameters in the study’s regression model after conducting diagnostic and preliminary tests to ascertain that the data set are reliable and not misleading. Empirical results show that there is an insignificant negative relationship between the environmental disclosure index (EDI) and the performance indices (ROA, ROE, and EPS) of the industrial goods manufacturing sectors in Nigeria. The study recommends that: only relevant information which increases the performance indices should appear on the disclosure checklist; environmental disclosure practices should be country-specific; and company executives in Nigeria should increase and monitor the level of investment (resources, time, and energy) in order to ensure that environmental disclosure has a significant impact on financial performance.

Keywords: earnings per share, environmental disclosures, return on assets, return on equity

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2908 Adaptive Process Monitoring for Time-Varying Situations Using Statistical Learning Algorithms

Authors: Seulki Lee, Seoung Bum Kim

Abstract:

Statistical process control (SPC) is a practical and effective method for quality control. The most important and widely used technique in SPC is a control chart. The main goal of a control chart is to detect any assignable changes that affect the quality output. Most conventional control charts, such as Hotelling’s T2 charts, are commonly based on the assumption that the quality characteristics follow a multivariate normal distribution. However, in modern complicated manufacturing systems, appropriate control chart techniques that can efficiently handle the nonnormal processes are required. To overcome the shortcomings of conventional control charts for nonnormal processes, several methods have been proposed to combine statistical learning algorithms and multivariate control charts. Statistical learning-based control charts, such as support vector data description (SVDD)-based charts, k-nearest neighbors-based charts, have proven their improved performance in nonnormal situations compared to that of the T2 chart. Beside the nonnormal property, time-varying operations are also quite common in real manufacturing fields because of various factors such as product and set-point changes, seasonal variations, catalyst degradation, and sensor drifting. However, traditional control charts cannot accommodate future condition changes of the process because they are formulated based on the data information recorded in the early stage of the process. In the present paper, we propose a SVDD algorithm-based control chart, which is capable of adaptively monitoring time-varying and nonnormal processes. We reformulated the SVDD algorithm into a time-adaptive SVDD algorithm by adding a weighting factor that reflects time-varying situations. Moreover, we defined the updating region for the efficient model-updating structure of the control chart. The proposed control chart simultaneously allows efficient model updates and timely detection of out-of-control signals. The effectiveness and applicability of the proposed chart were demonstrated through experiments with the simulated data and the real data from the metal frame process in mobile device manufacturing.

Keywords: multivariate control chart, nonparametric method, support vector data description, time-varying process

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2907 Analyzing the Food as a Form of Creativity: The Case of the Bijlmermeer in Amsterdam-Zuidoost

Authors: Marc Polo, Núria Arbonés Arán

Abstract:

Amsterdam is considered one of the great European capitals, which concentrates the headquarters of various multinational companies and which, in addition, enjoys a huge tourist attraction. Its typical residential buildings next to the canals, the museums, or its striking "Red Light District" are a great focus of attraction. In 2019 almost 9 million tourists visited it, but few of them traveled to the farthest neighborhood in the city: Amsterdam-Zuidoost (Amsterdam-Southeast). This neighborhood is geographically separated from the urban core, which makes it an exclave of Amsterdam as it does not border any of the other boroughs. Bijlmermeer neighborhood is the largest of the Amsterdam-Zuidoost, and it was born in the 1960s with the expectations of becoming the city of the future. Its main architect, Siegfried Nassuth, was inspired by the Swiss Le Corbusier to design nearly 18,000 homes, most of which were in high-rise tower blocks and built together, forming a recognizable "honeycombed" pattern. For more than 40 years, a series of infrastructure and social vicissitudes have made the neighborhood outline quite different as it was expected to be. It helped also varied elements such as ethnicity, demolitions, or unoccupied apartments. The called “city of the future” became home to immigrants, drug addicts, and vandals, and the conflicts denigrated the Amsterdam-Zuidoost. This work analyzes the evolution of the Bijlmermeer from its origins and illustrates relevant international referents able to help the area. The purpose of the work is to show how different variations along the recent history didn't help enough, but how there are positive perspectives for the future taking advantage of the food as a creative issue. The research, based on academic literature, existing material in different stadiums, plus the analysis of the city imaginaries, will help to concrete relevant elements in terms of innovation, creativity, and disruption. Despite of radical renewal that is taking place, the research will demonstrate that there are still new opportunities for the old Bijlmermeer.

Keywords: amsterdam, bijlmermeer, creativity, food

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2906 Agroforestry Systems and Practices and Its Adoption in Kilombero Cluster of Sagcot, Tanzania

Authors: Lazaro E. Nnko, Japhet J. Kashaigili, Gerald C. Monela, Pantaleo K. T. Munishi

Abstract:

Agroforestry systems and practices are perceived to improve livelihood and sustainable management of natural resources. However, their adoption in various regions differs with the biophysical conditions and societal characteristics. This study was conducted in Kilombero District to investigate the factors influencing the adoption of different agroforestry systems and practices in agro-ecosystems and farming systems. A household survey, key informant interviews, and focus group discussion was used for data collection in three villages. Descriptive statistics and multinomial logistic regression in SPSS were applied for analysis. Results show that Igima and Ngajengwa villages had home garden practices dominated, as revealed by 63.3% and 66.7%, respectively, while Mbingu village had mixed intercropping practice with 56.67%. Agrosilvopasture systems were dominant in Igima and Ngajengwa villages with 56.7% and 66.7%, respectively, while in Mbingu village, the dominant system was agrosilviculture with 66.7%. The results from multinomial logistic regression show that different explanatory variable was statistical significance as predictors of the adoption of agroforestry systems and practices. Residence type and sex were the most dominant factor influencing the adoption of agroforestry systems. Duration of stay in the village, availability of extension education, residence, and sex were the dominant factor influencing the adoption of agroforestry practices. The most important and statistically significant factors among these were residence type and sex. The study concludes that agroforestry will be more successful if the local priorities, which include social-economic need characteristics of the society, will be considered in designing systems and practices. The socio-economic need of the community should be addressed in the process of expanding the adoption of agroforestry systems and practices.

Keywords: agroforestry adoption, agroforestry systems, agroforestry practices, agroforestry, Kilombero

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2905 High-Capacity Image Steganography using Wavelet-based Fusion on Deep Convolutional Neural Networks

Authors: Amal Khalifa, Nicolas Vana Santos

Abstract:

Steganography has been known for centuries as an efficient approach for covert communication. Due to its popularity and ease of access, image steganography has attracted researchers to find secure techniques for hiding information within an innocent looking cover image. In this research, we propose a novel deep-learning approach to digital image steganography. The proposed method, DeepWaveletFusion, uses convolutional neural networks (CNN) to hide a secret image into a cover image of the same size. Two CNNs are trained back-to-back to merge the Discrete Wavelet Transform (DWT) of both colored images and eventually be able to blindly extract the hidden image. Based on two different image similarity metrics, a weighted gain function is used to guide the learning process and maximize the quality of the retrieved secret image and yet maintaining acceptable imperceptibility. Experimental results verified the high recoverability of DeepWaveletFusion which outperformed similar deep-learning-based methods.

Keywords: deep learning, steganography, image, discrete wavelet transform, fusion

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2904 Energy-Efficient Clustering Protocol in Wireless Sensor Networks for Healthcare Monitoring

Authors: Ebrahim Farahmand, Ali Mahani

Abstract:

Wireless sensor networks (WSNs) can facilitate continuous monitoring of patients and increase early detection of emergency conditions and diseases. High density WSNs helps us to accurately monitor a remote environment by intelligently combining the data from the individual nodes. Due to energy capacity limitation of sensors, enhancing the lifetime and the reliability of WSNs are important factors in designing of these networks. The clustering strategies are verified as effective and practical algorithms for reducing energy consumption in WSNs and can tackle WSNs limitations. In this paper, an Energy-efficient weight-based Clustering Protocol (EWCP) is presented. Artificial retina is selected as a case study of WSNs applied in body sensors. Cluster heads’ (CHs) selection is equipped with energy efficient parameters. Moreover, cluster members are selected based on their distance to the selected CHs. Comparing with the other benchmark protocols, the lifetime of EWCP is improved significantly.

Keywords: WSN, healthcare monitoring, weighted based clustering, lifetime

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2903 The role of Financial Development and Institutional Quality in Promoting Sustainable Development through Tourism Management

Authors: Hashim Zameer

Abstract:

Effective tourism management plays a vital role in promoting sustainability and supporting ecosystems. A common principle that has been in practice over the years is “first pollute and then clean,” indicating countries need financial resources to promote sustainability. Financial development and the tourism management both seems very important to promoting sustainable development. However, without institutional support, it is very difficult to succeed. In this context, it seems prominently significant to explore how institutional quality, tourism development, and financial development could promote sustainable development. In the past, no research explored the role of tourism development in sustainable development. Moreover, the role of financial development, natural resources, and institutional quality in sustainable development is also ignored. In this regard, this paper aims to investigate the role of tourism development, natural resources, financial development, and institutional quality in sustainable development in China. The study used time-series data from 2000–2021 and employed the Bayesian linear regression model because it is suitable for small data sets. The robustness of the findings was checked using a quantile regression approach. The results reveal that an increase in tourism expenditures stimulates the economy, creates jobs, encourages cultural exchange, and supports sustainability initiatives. Moreover, financial development and institution quality have a positive effect on sustainable development. However, reliance on natural resources can result in negative economic, social, and environmental outcomes, highlighting the need for resource diversification and management to reinforce sustainable development. These results highlight the significance of financial development, strong institutions, sustainable tourism, and careful utilization of natural resources for long-term sustainability. The study holds vital insights for policy formulation to promote sustainable tourism.

Keywords: sustainability, tourism development, financial development, institutional quality

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2902 Application of Grey Theory in the Forecast of Facility Maintenance Hours for Office Building Tenants and Public Areas

Authors: Yen Chia-Ju, Cheng Ding-Ruei

Abstract:

This study took case office building as subject and explored the responsive work order repair request of facilities and equipment in offices and public areas by gray theory, with the purpose of providing for future related office building owners, executive managers, property management companies, mechanical and electrical companies as reference for deciding and assessing forecast model. Important conclusions of this study are summarized as follows according to the study findings: 1. Grey Relational Analysis discusses the importance of facilities repair number of six categories, namely, power systems, building systems, water systems, air conditioning systems, fire systems and manpower dispatch in order. In terms of facilities maintenance importance are power systems, building systems, water systems, air conditioning systems, manpower dispatch and fire systems in order. 2. GM (1,N) and regression method took maintenance hours as dependent variables and repair number, leased area and tenants number as independent variables and conducted single month forecast based on 12 data from January to December 2011. The mean absolute error and average accuracy of GM (1,N) from verification results were 6.41% and 93.59%; the mean absolute error and average accuracy of regression model were 4.66% and 95.34%, indicating that they have highly accurate forecast capability.

Keywords: rey theory, forecast model, Taipei 101, office buildings, property management, facilities, equipment

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2901 The Effect of Geographical Differentials of Epidemiological Transition on Health-Seeking Behavior in India

Authors: Sumit Kumar Das, Laishram Ladusingh

Abstract:

Aim: The aim of the study is to examine the differential of epidemiological transition across fifteen agro-climatic zones of India and its effect on health-seeking behavior. Data and Methods: Unit level data on consumption expenditure on health of India from three decadal rounds conducted by National Sample Survey Organization are used for the analysis. These three rounds are 52nd (1995-96), 60th (2004-05) and 71st (2014-15). The age-adjusted prevalence rate for communicable diseases and non-communicable diseases are estimated for fifteen agro-climatic zones of India for three time periods. Bivariate analysis is used to find out determinants of health-seeking behavior. Multilevel logistic regression is used to examine factors effecting on household health-seeking behavior. Result: The prevalence of communicable diseases is increasing in most of the zones of India. Every South Indian zones, Gujarat plains, and lower Gangetic plain are facing the severe attack of dual burden of diseases. Demand for medical advice has increased in southern zones, and east zones, reliance on private healthcare facilities are increasing in most of the zone. Demographic characteristics of the household head have a significant impact on health-seeking behavior. Conclusion: Proper program implementation is required considering the disease prevalence and differential in the pattern of health seeking behavior. Along with initiation and strengthening of programs for non-communicable, existing programs for communicable diseases need to monitor and supervised strictly.

Keywords: agro-climatic zone, epidemiological transition, health-seeking behavior, multilevel regression

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2900 A Fuzzy Satisfactory Optimization Method Based on Stress Analysis for a Hybrid Composite Flywheel

Authors: Liping Yang, Curran Crawford, Jr. Ren, Zhengyi Ren

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Considering the cost evaluation and the stress analysis, a fuzzy satisfactory optimization (FSO) method has been developed for a hybrid composite flywheel. To evaluate the cost, the cost coefficients of the flywheel components are obtained through calculating the weighted sum of the scores of the material manufacturability, the structure character, and the material price. To express the satisfactory degree of the energy, the cost, and the mass, the satisfactory functions are proposed by using the decline function and introducing a satisfactory coefficient. To imply the different significance of the objectives, the object weight coefficients are defined. Based on the stress analysis of composite material, the circumferential and radial stresses are considered into the optimization formulation. The simulations of the FSO method with different weight coefficients and storage energy density optimization (SEDO) method of a flywheel are contrasted. The analysis results show that the FSO method can satisfy different requirements of the designer and the FSO method with suitable weight coefficients can replace the SEDO method.

Keywords: flywheel energy storage, fuzzy, optimization, stress analysis

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2899 Factors Contributing to Delayed Diagnosis and Treatment of Breast Cancer and Its Outcome in Jamhoriat Hospital Kabul, Afghanistan

Authors: Ahmad Jawad Fardin

Abstract:

Over 60% of patients with breast cancer in Afghanistan present late with advanced stage III and IV, a major cause for the poor survival rate. The objectives of this study were to identify the contributing factors for the diagnosis and treatment delay and its outcome. This cross-sectional study was conducted on 318 patients with histologically confirmed breast cancer in the oncology department of Jamhoriat hospital, which is the first and only national cancer center in Afghanistan; data were collected from medical records and interviews conducted with women diagnosed with breast cancer, linear regression and logistic regression were used for analysis. Patient delay was defined as the time from first recognition of symptoms until first medical consultation and doctor form first consultation with a health care provider until histological confirmation of breast cancer. The mean age of patients was 49.2+_ 11.5years. The average time for the final diagnosis of breast cancer was 8.5 months; most patients had ductal carcinoma 260.7 (82%). Factors associated with delay were low education level 76% poor socioeconomic and cultural conditions 81% lack of cancer center 73% lack of screening 19%. The stage distribution was as follows stage IV 4 22% stage III 44.4% stage II 29.3% stage I 4.3%. Complex associated factors were identified to delayed the diagnosis of breast cancer and increased adverse outcomes consequently. Raising awareness and education in women, the establishment of cancer centers and providing accessible diagnosis service and screening, training of general practitioners; required to promote early detection, diagnosis and treatment.

Keywords: delayed diagnosis and poor outcome, breast cancer in Afghanistan, poor outcome of delayed breast cancer treatment, breast cancer delayed diagnosis and treatment in Afghanistan

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2898 Optimizing Skill Development in Golf Putting: An Investigation of Blocked, Random, and Increasing Practice Schedules

Authors: John White

Abstract:

This study investigated the effects of practice schedules on learning and performance in golf putting, specifically focusing on the impact of increasing contextual interference (CI). University students (n=7) were randomly assigned to blocked, random, or increasing practice schedules. During acquisition, participants performed 135 putting trials using different weighted golf balls. The blocked group followed a specific sequence of ball weights, while the random group practiced with the balls in a random order. The increasing group started with a blocked schedule, transitioned to a serial schedule, and concluded with a random schedule. Retention and transfer tests were conducted 24 hours later. The results indicated that high levels of CI (random practice) were more beneficial for learning than low levels of CI (blocked practice). The increasing practice schedule, incorporating blocked, serial, and random practice, demonstrated advantages over traditional blocked and random schedules. Additionally, EEG was used to explore the neurophysiological effects of the increasing practice schedule.

Keywords: skill acquisition, motor control, learning, contextual interference

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2897 Machine Learning Framework: Competitive Intelligence and Key Drivers Identification of Market Share Trends among Healthcare Facilities

Authors: Anudeep Appe, Bhanu Poluparthi, Lakshmi Kasivajjula, Udai Mv, Sobha Bagadi, Punya Modi, Aditya Singh, Hemanth Gunupudi, Spenser Troiano, Jeff Paul, Justin Stovall, Justin Yamamoto

Abstract:

The necessity of data-driven decisions in healthcare strategy formulation is rapidly increasing. A reliable framework which helps identify factors impacting a healthcare provider facility or a hospital (from here on termed as facility) market share is of key importance. This pilot study aims at developing a data-driven machine learning-regression framework which aids strategists in formulating key decisions to improve the facility’s market share which in turn impacts in improving the quality of healthcare services. The US (United States) healthcare business is chosen for the study, and the data spanning 60 key facilities in Washington State and about 3 years of historical data is considered. In the current analysis, market share is termed as the ratio of the facility’s encounters to the total encounters among the group of potential competitor facilities. The current study proposes a two-pronged approach of competitor identification and regression approach to evaluate and predict market share, respectively. Leveraged model agnostic technique, SHAP, to quantify the relative importance of features impacting the market share. Typical techniques in literature to quantify the degree of competitiveness among facilities use an empirical method to calculate a competitive factor to interpret the severity of competition. The proposed method identifies a pool of competitors, develops Directed Acyclic Graphs (DAGs) and feature level word vectors, and evaluates the key connected components at the facility level. This technique is robust since its data-driven, which minimizes the bias from empirical techniques. The DAGs factor in partial correlations at various segregations and key demographics of facilities along with a placeholder to factor in various business rules (for ex. quantifying the patient exchanges, provider references, and sister facilities). Identified are the multiple groups of competitors among facilities. Leveraging the competitors' identified developed and fine-tuned Random Forest Regression model to predict the market share. To identify key drivers of market share at an overall level, permutation feature importance of the attributes was calculated. For relative quantification of features at a facility level, incorporated SHAP (SHapley Additive exPlanations), a model agnostic explainer. This helped to identify and rank the attributes at each facility which impacts the market share. This approach proposes an amalgamation of the two popular and efficient modeling practices, viz., machine learning with graphs and tree-based regression techniques to reduce the bias. With these, we helped to drive strategic business decisions.

Keywords: competition, DAGs, facility, healthcare, machine learning, market share, random forest, SHAP

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2896 A Geospatial Approach to Coastal Vulnerability Using Satellite Imagery and Coastal Vulnerability Index: A Case Study Mauritius

Authors: Manta Nowbuth, Marie Anais Kimberley Therese

Abstract:

The vulnerability of coastal areas to storm surges stands as a critical global concern. The increasing frequency and intensity of extreme weather events have increased the risks faced by communities living along the coastlines Worldwide. Small Island developing states (SIDS) stands out as being exceptionally vulnerable, coastal regions, ecosystems of human habitation and natural forces, bear witness to the frontlines of climate-induced challenges, and the intensification of storm surges underscores the urgent need for a comprehensive understanding of coastal vulnerability. With limited landmass, low-lying terrains, and resilience on coastal resources, SIDS face an amplified vulnerability to the consequences of storm surges, the delicate balance between human activities and environmental dynamics in these island nations increases the urgency of tailored strategies for assessing and mitigating coastal vulnerability. This research uses an approach to evaluate the vulnerability of coastal communities in Mauritius. The Satellite imagery analysis makes use of sentinel satellite imageries, modified normalised difference water index, classification techniques and the DSAS add on to quantify the extent of shoreline erosion or accumulation, providing a spatial perspective on coastal vulnerability. The coastal Vulnerability Index (CVI) is applied by Gonitz et al Formula, this index considers factors such as coastal slope, sea level rise, mean significant wave height, and tidal range. Weighted assessments identify regions with varying levels of vulnerability, ranging from low to high. The study was carried out in a Village Located in the south of Mauritius, namely Rivière des Galets, with a population of about 500 people over an area of 60,000m². The Village of Rivière des Galets being located in the south, and the southern coast of Mauritius being exposed to the open Indian ocean, is vulnerable to swells, The swells generated by the South east trade winds can lead to large waves and rough sea conditions along the Southern Coastline which has an impact on the coastal activities, including fishing, tourism and coastal Infrastructures, hence, On the one hand, the results highlighted that from a stretch of 123km of coastline the linear rate regression for the 5 –year span varies from-24.1m/yr. to 8.2m/yr., the maximum rate of change in terms of eroded land is -24m/yr. and the maximum rate of accretion is 8.2m/yr. On the other hand, the coastal vulnerability index varies from 9.1 to 45.6 and it was categorised into low, moderate, high and very high risks zones. It has been observed that region which lacks protective barriers and are made of sandy beaches are categorised as high risks zone and hence it is imperative to high risk regions for immediate attention and intervention, as they will most likely be exposed to coastal hazards and impacts from climate change, which demands proactive measures for enhanced resilience and sustainable adaptation strategies.

Keywords: climate change, coastal vulnerability, disaster management, remote sensing, satellite imagery, storm surge

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2895 Cigarette Smoking and Alcohol Use among Mauritian Adolescents: Analysis of 2017 WHO Global School-Based Student Health Survey

Authors: Iyanujesu Adereti, Tajudeen Basiru, Ayodamola Olanipekun

Abstract:

Background: Substance abuse among adolescents is of public health concern globally. Despite being the most abused by adolescents, there are limited studies on the prevalence of alcohol use and cigarette smoking among adolescents in Mauritius. Objectives: To determine the prevalence of cigarette smoking, alcohol use and associated correlates among school-going adolescents in Mauritius. Methodology: Data obtained from 2017 WHO Global School-based Student Health Survey (GSHS) survey of 3,012 school-going adolescents in Mauritius was analyzed using STATA. Descriptive statistics were used to obtain prevalence. Bivariate and multivariate logistic regression analysis was used to evaluate predictors of cigarette smoking and alcohol use. Results: Prevalence of alcohol consumption and cigarette smoking were 26.0% and 17.1%, respectively. Smoking and alcohol use was more prevalent among males, younger adolescents, and those in higher school grades (p-value <.000). In multivariable logistic regression, male gender was associated with a higher risk of cigarette smoking (adjusted Odds Ratio (aOR) [95%Confidence Interval (CI)]= 1.51[1.06-2.14]) but lower risk of alcohol use (aOR[95%CI]= 0.69[0.53-0.90]) while older age (mid and late adolescence) and parental smoking were found to be associated with increased risk of alcohol use (aOR[95%CI]= 1.94[1.34-2.99] and 1.36[1.05-1.78] respectively). Marijuana use, truancy, being in a fight and suicide ideation were associated with increased odds of alcohol use (aOR[95%CI]= 3.82[3.39-6.09]; 2.15[1.62-2.87]; 1.83[1.34-2.49] and 1.93[1.38-2.69] respectively) and cigarette smoking (aOR[95%CI]= 17.28[10.4 - 28.51]; 1.73[1.21-2. 49]; 1.67[1.14-2.45] and 2.17[1.43-3.28] respectively) while involvement in sexual activity was associated with reduced risk of alcohol use (aOR[95%CI]= 0.50[0.37-0.68]) and cigarette smoking (aOR[95%CI]= 0.47[0.33-0.69]). Parental support and parental monitoring were uniquely associated with lower risk of cigarette smoking (aOR[95%CI]= 0.69[0.47-0.99] and 0.62[0.43-0.91] respectively). Conclusion: The high prevalence of alcohol use and cigarette smoking in this study shows the need for the government of Mauritius to enhance policies that will help address this issue putting into accounts the various risk and protective factors.

Keywords: adolescent health, alcohol use, cigarette smoking, global school-based student health survey

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2894 The Effect of Climate on Noble Houses of Siraf in the Early Islamic Centuries (Case Study: House N)

Authors: Mohadese Sukhtesaraii, Mohammad Esmail Esmaili Jelodar, Kosar Sookhtesaraii

Abstract:

Throughout history, humans have always wanted to have a shelter to live in, and this need and desire became the beginning of building and architecture. It was necessary to build a shelter and a building, dealing with the surrounding nature. The design and construction of architectural spaces are always influenced by nature, climate, and geographical location, and It is believed clearly see this influence even in the use of materials used in the construction of architectural buildings. The historical port of Siraf is located on the northern coast of the Persian Gulf in Bushehr province and 38 km from Kangan port. Geographically and climatically, Siraf is considered one of the hot and humid areas. The Zagros mountains, which continue from the Iranian plateau to the sea, end at Bandar Siraf; As a result, it creates a strip one kilometer wide by the sea. The location of Siraf in the restrictive conditions of the mountains and the sea has made it impossible to expand the city. The main goal of the current research is to investigate the climate of Siraf and the influence of the region's climate on the architecture and design of residential buildings in Siraf, known as noble houses, in the early Islamic centuries. In this research, it is looking for an answer to the question of how the climatic and geographical conditions have affected the architecture of Siraf buildings. The theoretical framework of this research can be expressed based on the influence of climate on the historical architecture of Bandar Seraf and the spatial analysis of archeology. Also, the research method will be analytical-descriptive and using field and library studies. The authors of the article believe that the architectural spaces of the early Islamic centuries of Siraf city were affected by the climate and geographical location, and the architects started building buildings by considering factors such as the sun's radiation, wind direction, and the position of the mountains and the sea. To use the regional and environmental potential for buildings.

Keywords: hose N, noble hose, islamic era, siraf, climate

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2893 Flow and Heat Transfer Analysis of Copper-Water Nanofluid with Temperature Dependent Viscosity past a Riga Plate

Authors: Fahad Abbasi

Abstract:

Flow of electrically conducting nanofluids is of pivotal importance in countless industrial and medical appliances. Fluctuations in thermophysical properties of such fluids due to variations in temperature have not received due attention in the available literature. Present investigation aims to fill this void by analyzing the flow of copper-water nanofluid with temperature dependent viscosity past a Riga plate. Strong wall suction and viscous dissipation have also been taken into account. Numerical solutions for the resulting nonlinear system have been obtained. Results are presented in the graphical and tabular format in order to facilitate the physical analysis. An estimated expression for skin friction coefficient and Nusselt number are obtained by performing linear regression on numerical data for embedded parameters. Results indicate that the temperature dependent viscosity alters the velocity, as well as the temperature of the nanofluid and, is of considerable importance in the processes where high accuracy is desired. Addition of copper nanoparticles makes the momentum boundary layer thinner whereas viscosity parameter does not affect the boundary layer thickness. Moreover, the regression expressions indicate that magnitude of rate of change in effective skin friction coefficient and Nusselt number with respect to nanoparticles volume fraction is prominent when compared with the rate of change with variable viscosity parameter and modified Hartmann number.

Keywords: heat transfer, peristaltic flows, radially varying magnetic field, curved channel

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2892 The Role of Urban Development Patterns for Mitigating Extreme Urban Heat: The Case Study of Doha, Qatar

Authors: Yasuyo Makido, Vivek Shandas, David J. Sailor, M. Salim Ferwati

Abstract:

Mitigating extreme urban heat is challenging in a desert climate such as Doha, Qatar, since outdoor daytime temperature area often too high for the human body to tolerate. Recent studies demonstrate that cities in arid and semiarid areas can exhibit ‘urban cool islands’ - urban areas that are cooler than the surrounding desert. However, the variation of temperatures as a result of the time of day and factors leading to temperature change remain at the question. To address these questions, we examined the spatial and temporal variation of air temperature in Doha, Qatar by conducting multiple vehicle-base local temperature observations. We also employed three statistical approaches to model surface temperatures using relevant predictors: (1) Ordinary Least Squares, (2) Regression Tree Analysis and (3) Random Forest for three time periods. Although the most important determinant factors varied by day and time, distance to the coast was the significant determinant at midday. A 70%/30% holdout method was used to create a testing dataset to validate the results through Pearson’s correlation coefficient. The Pearson’s analysis suggests that the Random Forest model more accurately predicts the surface temperatures than the other methods. We conclude with recommendations about the types of development patterns that show the greatest potential for reducing extreme heat in air climates.

Keywords: desert cities, tree-structure regression model, urban cool Island, vehicle temperature traverse

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2891 Calculation of Pressure-Varying Langmuir and Brunauer-Emmett-Teller Isotherm Adsorption Parameters

Authors: Trevor C. Brown, David J. Miron

Abstract:

Gas-solid physical adsorption methods are central to the characterization and optimization of the effective surface area, pore size and porosity for applications such as heterogeneous catalysis, and gas separation and storage. Properties such as adsorption uptake, capacity, equilibrium constants and Gibbs free energy are dependent on the composition and structure of both the gas and the adsorbent. However, challenges remain, in accurately calculating these properties from experimental data. Gas adsorption experiments involve measuring the amounts of gas adsorbed over a range of pressures under isothermal conditions. Various constant-parameter models, such as Langmuir and Brunauer-Emmett-Teller (BET) theories are used to provide information on adsorbate and adsorbent properties from the isotherm data. These models typically do not provide accurate interpretations across the full range of pressures and temperatures. The Langmuir adsorption isotherm is a simple approximation for modelling equilibrium adsorption data and has been effective in estimating surface areas and catalytic rate laws, particularly for high surface area solids. The Langmuir isotherm assumes the systematic filling of identical adsorption sites to a monolayer coverage. The BET model is based on the Langmuir isotherm and allows for the formation of multiple layers. These additional layers do not interact with the first layer and the energetics are equal to the adsorbate as a bulk liquid. This BET method is widely used to measure the specific surface area of materials. Both Langmuir and BET models assume that the affinity of the gas for all adsorption sites are identical and so the calculated adsorbent uptake at the monolayer and equilibrium constant are independent of coverage and pressure. Accurate representations of adsorption data have been achieved by extending the Langmuir and BET models to include pressure-varying uptake capacities and equilibrium constants. These parameters are determined using a novel regression technique called flexible least squares for time-varying linear regression. For isothermal adsorption the adsorption parameters are assumed to vary slowly and smoothly with increasing pressure. The flexible least squares for pressure-varying linear regression (FLS-PVLR) approach assumes two distinct types of discrepancy terms, dynamic and measurement for all parameters in the linear equation used to simulate the data. Dynamic terms account for pressure variation in successive parameter vectors, and measurement terms account for differences between observed and theoretically predicted outcomes via linear regression. The resultant pressure-varying parameters are optimized by minimizing both dynamic and measurement residual squared errors. Validation of this methodology has been achieved by simulating adsorption data for n-butane and isobutane on activated carbon at 298 K, 323 K and 348 K and for nitrogen on mesoporous alumina at 77 K with pressure-varying Langmuir and BET adsorption parameters (equilibrium constants and uptake capacities). This modeling provides information on the adsorbent (accessible surface area and micropore volume), adsorbate (molecular areas and volumes) and thermodynamic (Gibbs free energies) variations of the adsorption sites.

Keywords: Langmuir adsorption isotherm, BET adsorption isotherm, pressure-varying adsorption parameters, adsorbate and adsorbent properties and energetics

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2890 Competing Risks Modeling Using within Node Homogeneity Classification Tree

Authors: Kazeem Adesina Dauda, Waheed Babatunde Yahya

Abstract:

To design a tree that maximizes within-node homogeneity, there is a need for a homogeneity measure that is appropriate for event history data with multiple risks. We consider the use of Deviance and Modified Cox-Snell residuals as a measure of impurity in Classification Regression Tree (CART) and compare our results with the results of Fiona (2008) in which homogeneity measures were based on Martingale Residual. Data structure approach was used to validate the performance of our proposed techniques via simulation and real life data. The results of univariate competing risk revealed that: using Deviance and Cox-Snell residuals as a response in within node homogeneity classification tree perform better than using other residuals irrespective of performance techniques. Bone marrow transplant data and double-blinded randomized clinical trial, conducted in other to compare two treatments for patients with prostate cancer were used to demonstrate the efficiency of our proposed method vis-à-vis the existing ones. Results from empirical studies of the bone marrow transplant data showed that the proposed model with Cox-Snell residual (Deviance=16.6498) performs better than both the Martingale residual (deviance=160.3592) and Deviance residual (Deviance=556.8822) in both event of interest and competing risks. Additionally, results from prostate cancer also reveal the performance of proposed model over the existing one in both causes, interestingly, Cox-Snell residual (MSE=0.01783563) outfit both the Martingale residual (MSE=0.1853148) and Deviance residual (MSE=0.8043366). Moreover, these results validate those obtained from the Monte-Carlo studies.

Keywords: within-node homogeneity, Martingale residual, modified Cox-Snell residual, classification and regression tree

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2889 The Associations between Self-Determined Motivation and Physical Activity in Patients with Coronary Heart Disease

Authors: I. Hua Chu, Hsiang-Chi Yu, Hsuan Su

Abstract:

Purpose: To examine the associations between self-determined motivation and physical activity in patients with coronary heart disease (CHD) in a longitudinal study. Methods: Patients with CHD were recruited for this study. Their motivations for exercise were measured by the Behavioral Regulation in Exercise Questionnaire-2 (BREQ-2). Physical activity was assessed using the 7-day physical activity recall questionnaire. Duration and energy expenditure of moderate to vigorous physical activity (MVPA) were used in data analysis. All outcome measures were assessed at baseline and 12 months follow up. Data were analyzed using Pearson correlation analysis and regression analysis. Results: The results of the 45 participants (mean age 60.24 yr; 90.2% male) revealed that there were significant negative correlations between amotivation at baseline and duration (r=-.295, p=.049) and energy expenditure (r=-.300, p=.045) of MVPA at 12 months. In contrast, there were significant positive correlations between calculated relative autonomy index (RAI) at baseline and duration (r=.377, p=.011) and energy expenditure (r=.382, p=.010) of MVPA at 12 months. There was no significant correlation between other subscales of the BREQ-2 and duration or energy expenditure of MVPA. Regression analyses revealed that RAI was a significant predictor of duration (p=.011) and energy expenditure (p=.010) of MVPA at 12 months follow-up. Conclusions: These results suggest that the relative degree of self-determined motivation could predict long-term MVPA behaviors in CHD patients. Physical activity interventions are recommended to target enhancing one’s identified and intrinsic motivation to increase the likelihood of physical activity participation in this population.

Keywords: self-determined motivation, physical activity, coronary heart disease, relative autonomy index (RAI)

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2888 Relationship and Associated Factors of Breastfeeding Self-efficacy among Postpartum Couples in Malawi: A Cross-sectional Study

Authors: Roselyn Chipojola, Shu-yu Kuo

Abstract:

Background: Breastfeeding self-efficacy in both mothers and fathers play a crucial role in improving exclusive breastfeeding rates. However, less is known on the relationship and predictors of paternal and maternal breastfeeding self-efficacy. This study aimed to examine the relationship and associated factors of breastfeeding self-efficacy (BSE) among mothers and fathers in Malawi. Methods: A cross-sectional study was conducted on 180 pairs of postpartum mothers and fathers at a tertiary maternity facility in central Malawi. BSE was measured using the Breastfeeding Self-Efficacy Scale Short-Form. Depressive symptoms were assessed by the Edinburgh Postnatal Depression Scale. A structured questionnaire was used to collect demographic and health variables. Data were analyzed using multivariable logistic regression and multinomial logistic regression. Results: A higher score of self-efficacy was found in mothers (mean=55.7, Standard Deviation (SD) =6.5) compared to fathers (mean=50.2, SD=11.9). A significant association between paternal and maternal breastfeeding self-efficacy was found (r= 0. 32). Age, employment status, mode of birth was significantly related to maternal and paternal BSE, respectively. Older age and caesarean section delivery were significant factors of combined BSE scores in couples. A higher BSE score in either the mother or her partner predicted higher exclusive breastfeeding rates. BSE scores were lower when couples’ depressive symptoms were high. Conclusion: BSE are highly correlated between Malawian mothers and fathers, with a relatively higher score in maternal BSE. Importantly, a high BSE in couples predicted higher odds of exclusive breastfeeding, which highlights the need to include both mothers and fathers in future breastfeeding promotion strategies.

Keywords: paternal, maternal, exclusive breastfeeding, breastfeeding self‑efficacy, malawi

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