Search results for: teaching and learning clinical practicum

Authors: Broto Seno

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This study aims to describe and examine more in the implementation of educational partnerships for undergraduate students at Yogyakarta State University (YSU), which is more focused on educational partnerships abroad. This study used descriptive qualitative approach. The study subjects consisted of a vice-rector, two staff education partnerships, four vice-dean, nine undergraduate students and three foreign students. Techniques of data collection using interviews and document review. Validity test of the data source using triangulation. Data analysis using flow models Miles and Huberman, namely data reduction, data display, and conclusion. Results of this study showed that the implementation of educational partnerships abroad for undergraduate students at YSU meets six of the nine indicators of the success of strategic partnerships. Six indicators are long-term, strategic, mutual trust, sustainable competitive advantages, mutual benefit for all the partners, and the separate and positive impact. The indicator has not been achieved is cooperative development, successful, and world class / best practice. These results were obtained based on the discussion of the four formulation of the problem, namely: 1) Implementation and development of educational partnerships abroad has been running good enough, but not maximized. 2) Benefits of the implementation of educational partnerships abroad is providing learning experiences for students, institutions of experience in comparison to each faculty, and improving the network of educational partnerships for YSU toward World Class University. 3) The sustainability of educational partnerships abroad is pursuing a strategy of development through improved management of the partnership. 4) Supporting factors of educational partnerships abroad is the support of YSU, YSU’s partner and society. Inhibiting factors of educational partnerships abroad is not running optimally management.

Keywords: partnership, education, YSU, institutions and faculties

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Authors: Sulemana Saibu, Moses Ikpeme

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Background: The severity of the COVID-19 pandemic, brought on by the SARS-CoV-2 coronavirus, has been unprecedented since the 1918 influenza pandemic. SARS-CoV-2 cases of CNS and peripheral nervous system disease, including neurodegenerative disorders and chronic immune-mediated diseases, may be anticipated based on knowledge of past coronaviruses, particularly those that caused the severe acute respiratory syndrome and Middle East respiratory syndrome outbreaks. Although respiratory symptoms are the most common clinical presentation, neurological symptoms are becoming increasingly recognized, raising concerns about their potential role in causing Parkinson's disease, Multiple sclerosis, and Narcolepsy. This systematic review aims to summarize the current evidence by exploring the association between COVID-19 infection and how it may overlap with etiological mechanisms resulting in Narcolepsy, Parkinson's disease, and Multiple sclerosis. Methods: A systematic search was conducted using electronic databases ((PubMed/MedLine, Embase, PsycINFO, ScieLO, Web of Science, ProQuest (Biotechnology, Virology, and AIDS), Scopus, and CINAHL)) to identify studies published between January 2020 and December 2022 that investigated the association between COVID-19 and Parkinson's disease, multiple sclerosis, and Narcolepsy. Per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the review was performed and reported. Study quality was assessed using the Critical Appraisal Skills Programme Checklist and the Joanna Briggs Institute Critical appraisal tools. Results: A total of 21 studies out of 1025 met the inclusion criteria, including 8 studies reporting Parkinson's disease, 11 on multiple sclerosis, and 2 on Narcolepsy. In COVID-19 individuals compared to the general population, Narcolepsy, Parkinson's disease, and multiple sclerosis were shown to have a higher incidence. The findings imply that COVID-19 may worsen the signs or induce multiple sclerosis and Parkinson's disease and may raise the risk of developing Narcolepsy. Further research is required to confirm these connections because the available data is insufficient. Conclusion: According to the existing data, COVID-19 may raise the risk of Narcolepsy and have a causative relationship with Parkinson's disease, multiple sclerosis, and other diseases. More study is required to confirm these correlations and pinpoint probable mechanisms behind these interactions. Clinicians should be aware of how COVID-19 may affect various neurological illnesses and should treat patients who are affected accordingly.

Keywords: COVID-19, parkinson’s disease, multiple sclerosis, narcolepsy, neurological disorders, sars-cov-2, neurodegenerative disorders, chronic immune-mediated diseases

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Authors: Ivonete Teresinha Schulter Buss Heidemann, Michelle Kuntz Durand, Aline Megumi Arakawa-Belaunde, Sandra Mara Corrêa, Leandro Martins Costa Do Araujo, Kamila Soares Maciel

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Primary Health Care is defined as the level of a system of services that enables the achievement of answers to health needs. This level of care produces services and actions of attention to the person in the life cycle and in their health conditions or diseases. Primary Health Care refers to a conception of care model and organization of the health system that in Brazil seeks to reorganize the principles of the Unified Health System. This system is based on the principle of health as a citizen's right and duty of the State. Primary health care has family health as a priority strategy for its organization according to the precepts of the Unified Health System, structured in the logic of new sectoral practices, associating clinical work and health promotion. Thus, this study seeks to know the possibilities and limits of the care developed by professionals working in Primary Health Care. It was conducted by a qualitative approach of the participant action type, based on Paulo Freire's Research Itinerary, which corresponds to three moments: Thematic Investigation; Encoding and Decoding; and, Critical Unveiling. The themes were investigated in a health unit with the development of a culture circle with 20 professionals, from a municipality in southern Brazil, in the first half of 2021. The participants revealed as possibilities the involvement, bonding and strengthening of the interpersonal relationships of the professionals who work in the context of primary care. Promoting welcoming in primary care has favoured care and teamwork, as well as improved access. They also highlighted that care planning, the use of technologies in the process of communication and the orientation of the population enhances the levels of problem-solving capacity and the organization of services. As limits, the lack of professional recognition and the scarce material and human resources were revealed, conditions that generate tensions for health care. The reduction in the number of professionals and the low salary are pointed out as elements that boost the motivation of the health team for the development of the work. The participants revealed that due to COVID-19, the flow of care had as a priority the pandemic situation, which affected health care in primary care, and prevention and health promotion actions were canceled. The study demonstrated that empowerment and professional involvement are fundamental to promoting comprehensive and problem-solving care. However, limits of the teams are observed when exercising their activities, these are related to the lack of human and material resources, and the expansion of public health policies is urgent.

Keywords: health promotion, primary health care, health professionals, welcoming.

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Authors: Tin Yee Ling, Kavita Maravar, Ruzica Ardalic

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Background: Uterine torsion (UT) in pregnancy of more than 45-degree along the longitudinal axis is a rare occurrence, and the aetiology remains unclear. Case: A 34-year-old G2P1 woman with a history of one previous caesarean section presented at 36+2 weeks with sudden onset lower abdominal pain, syncopal episode, and tender abdomen on examination. She was otherwise haemodynamically stable. Cardiotocography showed a pathological trace with initial prolonged bradycardia followed by a subsequent tachycardia with reduced variability. An initial diagnosis of uterine dehiscence was made, given the history and clinical presentation. She underwent an emergency caesarean section which revealed a 180-degree UT along the longitudinal axis, with oedematous left round ligament lying transverse anterior to the uterus and a segment of large bowel inferior to the round ligament. Detorsion of uterus was performed prior to delivery of the foetus, and anterior uterine wall was intact with no signs of rupture. There were no anatomical uterine abnormalities found other than stretched left ovarian and round ligaments, which were repaired. Delivery was otherwise uneventful, and she was discharged on day 2 postpartum. Discussion: UT is rare as the number of reported cases is within the few hundreds worldwide. Generally, the uterus is supported in place by uterine ligaments, which limit the mobility of the structure. The causes of UT are unknown, but risk factors such as uterine abnormalities, increased uterine ligaments’ flexibility in pregnancy, and foetal malposition has been identified. UT causes occlusion of uterine vessels, which can lead to ischaemic injury of the placenta causing premature separation of the placenta, preterm labour, and foetal morbidity and mortality if delivery is delayed. Diagnosing UT clinically is difficult as most women present with symptoms similar to placenta abruption or uterine rupture (abdominal pain, vaginal bleeding, shock), and one-third are asymptomatic. The management of UT involves surgical detorsion of the uterus and delivery of foetus via caesarean section. Extra vigilance should be taken to identify the anatomy of the uterus experiencing torsion prior to hysterotomy. There have been a few cases reported with hysterotomy on posterior uterine wall for delivery of foetus as it may be difficult to identify and reverse a gravid UT when foetal well-being is at stake. Conclusion: UT should be considered a differential diagnosis of acute abdominal pain in pregnancy. It is crucial that the torsion is addressed immediately as it is associated with maternal and foetal morbidity and mortality.

Keywords: uterine torsion, pregnancy complication, abdominal pain, torted uterus

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Authors: Neha Batra Bali, Monika Tomar, Vinay Gupta

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A reagentless biosensor for detection of urea based on ZnO-CuO composite thin film is presented in following work. Biosensors have immense potential for varied applications ranging from environmental to clinical testing, health care, and cell analysis. Immense growth in the field of biosensors is due to the huge requirement in today’s world to develop techniques which are both cost effective and accurate for prevention of disease manifestation. The human body comprises of numerous biomolecules which in their optimum levels are essential for functioning. However mismanaged levels of these biomolecules result in major health issues. Urea is one of the key biomolecules of interest. Its estimation is of paramount significance not only for healthcare sector but also from environmental perspectives. If level of urea in human blood/serum is abnormal, i.e., above or below physiological range (15-40mg/dl)), it may lead to diseases like renal failure, hepatic failure, nephritic syndrome, cachexia, urinary tract obstruction, dehydration, shock, burns and gastrointestinal, etc. Various metal nanoparticles, conducting polymer, metal oxide thin films, etc. have been exploited to act as matrix to immobilize urease to fabricate urea biosensor. Amongst them, Zinc Oxide (ZnO), a semiconductor metal oxide with a wide band gap is of immense interest as an efficient matrix in biosensors by virtue of its natural abundance, biocompatibility, good electron communication feature and high isoelectric point (9.5). In spite of being such an attractive candidate, ZnO does not possess a redox couple of its own which necessitates the use of electroactive mediators for electron transfer between the enzyme and the electrode, thereby causing hindrance in realization of integrated and implantable biosensor. In the present work, an effort has been made to fabricate a matrix based on ZnO-CuO composite prepared by pulsed laser deposition (PLD) technique in order to incorporate redox properties in ZnO matrix and to utilize the same for reagentless biosensing applications. The prepared bioelectrode Urs/(ZnO-CuO)/ITO/glass exhibits high sensitivity (70µAmM⁻¹cm⁻²) for detection of urea (5-200 mg/dl) with high stability (shelf life ˃ 10 weeks) and good selectivity (interference ˂ 4%). The enhanced sensing response obtained for composite matrix is attributed to the efficient electron exchange between ZnO-CuO matrix and immobilized enzymes, and subsequently fast transfer of generated electrons to the electrode via matrix. The response is encouraging for fabricating reagentless urea biosensor based on ZnO-CuO matrix.

Keywords: biosensor, reagentless, urea, ZnO-CuO composite

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Authors: Jixiang Lei, Alexander Fuchs, Franz Pernkopf, Katrin Ellermann

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Within the Space@Sea project, funded by the Horizon 2020 program, an island consisting of multiple platforms was designed. The platforms are connected by ropes and fenders. The connection is critical with respect to the safety of the whole system. Therefore, fault detection systems are investigated, which could detect early warning signs for a possible failure in the connection elements. Previously, a model-based method called Extended Kalman Filter was developed to detect the reduction of rope stiffness. This method detected several types of faults reliably, but some types of faults were much more difficult to detect. Furthermore, the model-based method is sensitive to environmental noise. When the wave height is low, a long time is needed to detect a fault and the accuracy is not always satisfactory. In this sense, it is necessary to develop a more accurate and robust technique that can detect all rope faults under a wide range of operational conditions. Inspired by this work on the Space at Sea design, we introduce a fault diagnosis method based on deep neural networks. Our method cannot only detect rope degradation by using the acceleration data from each platform but also estimate the contributions of the specific acceleration sensors using methods from explainable AI. In order to adapt to different operational conditions, the domain adaptation technique DANN is applied. The proposed model can accurately estimate rope degradation under a wide range of environmental conditions and help users understand the relationship between the output and the contributions of each acceleration sensor.

Keywords: fault diagnosis, deep learning, domain adaptation, explainable AI

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Authors: Christian Ndubisi Madu, Benjamin C. Ozumba, Ifeanyi E. Madu, Valentine E. Nnadi, Ikenna C. Ezeasor

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The ability to generate power and achieve energy security is one of the driving forces behind the emerging ‘microgrid’ concept. Traditional power supply often operates with centralized infrastructure for generating, transmitting and distributing electricity. The inefficiency and the incessant power outages associated with the centralized power supply system in Nigeria has alienated many users who frequently turn to electric power generator sets to power their homes and offices. Such acts are unsustainable and lead to increase in the use of fossil fuels, generation of carbon dioxide emissions and other gases, and noise pollution. They also pose significant risks as they entail random purchases and storage of gasolines which are fire hazards. It is therefore important that organizations rethink their relationships to centralized power suppliers in other to improve energy accessibility and security. This study explores the energy planning processes and learning taking place at the University of Nigeria Enugu Campus as the school lead microgrid feasibility studies in its community. There is need to develop community partners to deal with the issue of energy efficiency and also to create a strategic alliance to confront political, regulatory and economic barriers to locally-based energy planning. Community-based microgrid can help to reduce the cost of adoption and diversify risks. This study offers insights into the ways in which microgrids can further democratize energy planning, procurement, and access, while simultaneously promoting efficiency and sustainability.

Keywords: microgrid, energy efficiency, sustainability, energy security

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Authors: Ruvaitha Banu, Amaladhithyan Krishnamoorthy

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IoT networks today solve various consumer problems, from home automation systems to aiding in driving autonomous vehicles with the exploration of multiple devices. For example, in an autonomous vehicle environment, multiple sensors are available on roads to monitor weather and road conditions and interact with each other to aid the vehicle in reaching its destination safely and timely. IoT systems are predominantly dependent on the cloud environment for data storage, and computing needs that result in latency problems. With the advent of Fog networks, some of this storage and computing is pushed to the edge/fog nodes, saving the network bandwidth and reducing the latency proportionally. Managing the data stored in these fog nodes becomes crucial as it might also store sensitive information required for a certain application. Data management in fog nodes is strenuous because Fog networks are dynamic in terms of their availability and hardware capability. It becomes more challenging when the nodes in the network also live a short span, detaching and joining frequently. When an end-user or Fog Node wants to access, read, or write data stored in another Fog Node, then a new protocol becomes necessary to access/manage the data stored in the fog devices as a conventional static way of managing the data doesn’t work in Fog Networks. The proposed solution discusses a protocol that acts by defining sensitivity levels for the data being written and read. Additionally, a distinct data distribution and replication model among the Fog nodes is established to decentralize the access mechanism. In this paper, the proposed model implements stewardship towards the data stored in the Fog node using the application of Reinforcement Learning so that access to the data is determined dynamically based on the requests.

Keywords: IoT, fog networks, data stewardship, dynamic access policy

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Authors: Aneal Khan, Elleine Allapitan, Desmond Koo, Katherine-Ann Piedalue, Shaneel Pathak, Utkarsh Subnis

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Background: Disease management of metabolic, genetic disorders is long-term and can be cumbersome to patients and caregivers. Patient-Reported Outcome Measures (PROMs) have been a useful tool in capturing patient perspectives to help enhance treatment compliance and engagement with health care providers, reduce utilization of emergency services, and increase satisfaction with their treatment choices. Currently, however, PROMs are collected during infrequent and decontextualized clinic visits, which makes translation of patient experiences challenging over time. The GRIT study aims to evaluate a digital health journal application called Zamplo that provides a personalized health diary to record self-reported health outcomes accurately and efficiently in patients with metabolic, genetic disorders. Methods: This is a randomized controlled trial (RCT) (1:1) that assesses the efficacy of Zamplo to increase patient activation (primary outcome), improve healthcare satisfaction and confidence to manage medications (secondary outcomes), and reduce costs to the healthcare system (exploratory). Using standardized online surveys, assessments will be collected at baseline, 1 month, 3 months, 6 months, and 12 months. Outcomes will be compared between patients who were given access to the application versus those with no access. Results: Seventy-seven patients were recruited as of November 30, 2021. Recruitment for the study commenced in November 2020 with a target of n=150 patients. The accrual rate was 50% from those eligible and invited for the study, with the majority of patients having Fabry disease (n=48) and the remaining having Pompe disease and mitochondrial disease. Real-time clinical responses, such as pain, are being measured and correlated to disease-modifying therapies, supportive treatments like pain medications, and lifestyle interventions. Engagement with the application, along with compliance metrics of surveys and journal entries, are being analyzed. An interim analysis of the engagement data along with preliminary findings from this pilot RCT, and qualitative patient feedback will be presented. Conclusions: The digital self-care journal provides a unique approach to disease management, allowing patients direct access to their progress and actively participating in their care. Findings from the study can help serve the virtual care needs of patients with metabolic, genetic disorders in North America and the world over.

Keywords: eHealth, mobile health, rare disease, patient outcomes, quality of life (QoL), pain, Fabry disease, Pompe disease

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Authors: Moquan Gong

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In recent years, with the rapid development of deep learning, pre-training technology for natural language processing has made great progress. The early field of natural language processing has long used word vector methods such as Word2Vec to encode text. These word vector methods can also be regarded as static pre-training techniques. However, this context-free text representation brings very limited improvement to subsequent natural language processing tasks and cannot solve the problem of word polysemy. ELMo proposes a context-sensitive text representation method that can effectively handle polysemy problems. Since then, pre-training language models such as GPT and BERT have been proposed one after another. Among them, the BERT model has significantly improved its performance on many typical downstream tasks, greatly promoting the technological development in the field of natural language processing, and has since entered the field of natural language processing. The era of dynamic pre-training technology. Since then, a large number of pre-trained language models based on BERT and XLNet have continued to emerge, and pre-training technology has become an indispensable mainstream technology in the field of natural language processing. This article first gives an overview of pre-training technology and its development history, and introduces in detail the classic pre-training technology in the field of natural language processing, including early static pre-training technology and classic dynamic pre-training technology; and then briefly sorts out a series of enlightening technologies. Pre-training technology, including improved models based on BERT and XLNet; on this basis, analyze the problems faced by current pre-training technology research; finally, look forward to the future development trend of pre-training technology.

Keywords: natural language processing, pre-training, language model, word vectors

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Authors: Lakmali Anthony, Madeline Gillies

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Background: Colorectal cancer (CRC) is usually managed with surgical resection. Many of the outcomes traditionally used to define successful operative management, such as resection margin, do not adequately reflect patients’ experience. Patient-reported outcomes (PRO), such as Health-Related Quality of life (HRQoL), provide a means by which the impact of surgery for cancer can be reported in a patient-centered way. HRQoL has previously been shown to be impacted by psychosocial, behavioral and disease-specific characteristics. This exploratory cross-sectional study aims to; (1) describe postoperative HRQoL in patients who underwent primary resection in a regional Australian hospital; (2) describe the prevalence of anxiety, depression and clinically significant fear of cancer recurrence (FCR) in this population; and (3) identify demographic, psychosocial, disease and treatment factors associated with poorer self-reported HRQoL. Methods: Consecutive patients who had resection of colorectal cancer in a single regional Australian hospital between 2015 and 2022 were eligible. Participants were asked to complete a survey instrument designed to assess HRQoL, as well as validated instruments that assess several other psychosocial PROs hypothesized to be associated with HRQoL; emotional distress, fear of cancer recurrence, social support, dispositional optimism, body image and spirituality. Demographic and disease-specific data were also collected via medical record review. Results: Forty-six patients completed the survey. Clinically significant levels of fear of recurrence as well as emotional distress, were present in this group. Many domains of HRQoL were significantly worse than an Australian reference population for CRC. Demographic and disease factors associated with poor HRQoL included smoking and ongoing adjuvant systemic therapy. The primary operation was not associated with HRQoL; however, the operative approach (laparoscopic vs. open) was associated with HRQoL for these patients. All psychosocial factors measured were associated with HRQoL, including cancer worry, emotional distress, body image and dispositional optimism. Conclusion: HRQoL is an important outcome in surgery for both research and clinical practice. This study provides an overview of the quality of life in a regional Australian population of postoperative colorectal cancer patients and the factors that affect it. Understanding HRQoL and awareness of patients particularly vulnerable to poor outcomes should be used to aid the informed consent and shared decision-making process between surgeon and patient.

Keywords: surgery, colorectal, cancer, PRO, HRQoL

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Authors: Heena Dabas, Anju Paul, Suman Chaurasia, Ramesh Agarwal, M. Jeeva Sankar, Anurag Bajpai, Manju Saksena

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Background: Traumatic lumbar puncture (LP) is a common occurrence and causes substantial diagnostic ambiguity. There is paucity of data regarding its epidemiology. Objective: To assess the incidence and risk factors of traumatic LP in newborns. Design/Methods: In a prospective cohort study, all inborn neonates admitted in NICU and planned to undergo LP for a clinical indication of sepsis were included. Neonates with diagnosed intraventricular hemorrhage (IVH) of grade III and IV were excluded. The LP was done by operator - often a fellow or resident assisted by bedside nurse. The unit has policy of not routinely using any sedation/analgesia during the procedure. LP is done by 26 G and 0.5-inch-long hypodermic needle inserted in third or fourth lumbar space while the infant is in lateral position. The infants were monitored clinically and by continuous measurement of vital parameters using multipara monitor during the procedure. The occurrence of traumatic tap along with CSF parameters and other operator and assistant characteristics were recorded at the time of procedure. Traumatic tap was defined as presence of visible blood or more than 500 red blood cells on microscopic examination. Microscopic trauma was defined when CSF is not having visible blood but numerous RBCs. The institutional ethics committee approved the study protocol. A written informed consent from the parents and the health care providers involved was obtained. Neonates were followed up till discharge/death and final diagnosis was assigned along with treating team. Results: A total of 362 (21%) neonates out of 1726 born at the hospital were admitted during the study period (July 2016 to January, 2017). Among these neonates, 97 (26.7%) were suspected of sepsis. A total of 54 neonates were enrolled who met the eligibility criteria and parents consented to participate in the study. The mean (SD) birthweight was 1536 (732) grams and gestational age 32.0 (4.0) weeks. All LPs were indicated for late onset sepsis at the median (IQR) age of 12 (5-39) days. The traumatic LP occurred in 19 neonates (35.1%; 95% C.I 22.6% to 49.3%). Frank blood was observed in 7 (36.8%) and in the remaining, 12(63.1%) CSF was detected to have microscopic trauma. The preliminary risk factor analysis including birth weight, gestational age and operator/assistant and other characteristics did not demonstrate clinically relevant predictors. Conclusion: A significant number of neonates requiring lumbar puncture in our study had high incidence of traumatic tap. We were not able to identify modifiable risk factors. There is a need to understand the reasons and further reduce this issue for improving management in NICUs.

Keywords: incidence, newborn, traumatic, lumbar puncture

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Authors: Julie M. Novak, Simone K. Brennan, Lacey Brim

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Undergraduate medical education (UME) curriculum notably addresses micro-level communications (e.g., patient-provider, intercultural, inter-professional), yet frequently under-examines the role and impact of organizational communication, a more macro-level. Organizational communication, however, functions as foundation and through systemic structures of an organization and thereby serves as hidden curriculum and influences learning experiences and outcomes. Yet, little available research exists fully examining how students experience organizational communication while in medical school. Extant literature and best practices provide insufficient guidance for UME programs, in particular. The purpose of this study was to map and examine current organizational communication systems and processes in a UME program. Employing a phenomenology-grounded and participatory approach, this study sought to understand the organizational communication system from medical students' perspective. The research team consisted of a core team and 13 medical student co-investigators. This research employed multiple methods, including focus groups, individual interviews, and two surveys (one reflective of focus group questions, the other requesting students to submit ‘examples’ of communications). To provide context for student responses, nonstudent participants (faculty, administrators, and staff) were sampled, as they too express concerns about communication. Over 400 students across all cohorts and 17 nonstudents participated. Data were iteratively analyzed and checked for triangulation. Findings reveal the complex nature of organizational communication and student-oriented communications. They reveal program-impactful strengths, weaknesses, gaps, and tensions and speak to the role of organizational communication practices influencing both climate and culture. With regard to communications, students receive multiple, simultaneous communications from multiple sources/channels, both formal (e.g., official email) and informal (e.g., social media). Students identified organizational strengths including the desire to improve student voice, and message frequency. They also identified weaknesses related to over-reliance on emails, numerous platforms with inconsistent utilization, incorrect information, insufficient transparency, assessment/input fatigue, tacit expectations, scheduling/deadlines, responsiveness, and mental health confidentiality concerns. Moreover, they noted gaps related to lack of coordination/organization, ambiguous point-persons, student ‘voice-only’, open communication loops, lack of core centralization and consistency, and mental health bridges. Findings also revealed organizational identity and cultural characteristics as impactful on the medical school experience. Cultural characteristics included program size, diversity, urban setting, student organizations, community-engagement, crisis framing, learning for exams, inefficient bureaucracy, and professionalism. Moreover, they identified system structures that do not always leverage cultural strengths or reduce cultural problematics. Based on the results, opportunities for productive change are identified. These include leadership visibly supporting and enacting overall organizational narratives, making greater efforts in consistently ‘closing the loop’, regularly sharing how student input effects change, employing strategies of crisis communication more often, strengthening communication infrastructure, ensuring structures facilitate effective operations and change efforts, and highlighting change efforts in informational communication. Organizational communication and communications are not soft-skills, or of secondary concern within organizations, rather they are foundational in nature and serve to educate/inform all stakeholders. As primary stakeholders, students and their success directly affect the accomplishment of organizational goals. This study demonstrates how inquiries about how students navigate their educational experience extends research-based knowledge and provides actionable knowledge for the improvement of organizational operations in UME.

Keywords: medical education programs, organizational communication, participatory research, qualitative mixed methods

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Authors: Teresa Caswell

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Throughout the United States and within a myriad of demographic contexts, students of color experience the results of systemic inequities as an academic outcome. These disparities continue despite the increased resources provided to students and ongoing instruction-focused professional learning received by teachers. The researcher postulated that lower levels of educator cultural competency are an underlying factor of why resource and instructional interventions are less effective than desired. Before implementing any type of intervention, however, cultural competency needed to be confirmed as a factor in schools demonstrating academic disparities between racial subgroups. A needs assessment was designed to measure levels of individual beliefs, including cultural competency, in both principals and teachers at three neighboring schools verified to have academic disparities. The resulting mixed method study utilized the Optimal Theory Applied to Identity Development (OTAID) model to measure cultural competency quantitatively, through self-identity inventory survey items, with teachers and qualitatively, through one-on-one interviews, with each school’s principal. A joint display was utilized to see combined data within and across school contexts. Each school was confirmed to have misalignments between principal and teacher levels of cultural competency beliefs while also indicating that a number of participants in the self-identity inventory survey may have intentionally skipped items referencing the term oppression. Additional use of the OTAID model and self-identity inventory in future research and across contexts is needed to determine transferability and dependability as cultural competency measures.

Keywords: cultural competency, identity development, mixed-method analysis, needs assessment

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Authors: Wenbo Wang, Yi-Fang Brook Wu

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The spread of misinformation and disinformation has become a major concern, particularly with the rise of social media as a primary source of information for many people. As a means to address this phenomenon, automated fact-checking has emerged as a safeguard against the spread of misinformation and disinformation. Existing fact-checking approaches aim to determine whether a news claim is true or false, and they have achieved decent veracity prediction accuracy. However, the state-of-the-art methods rely on manually verified external information to assist the checking model in making judgments, which requires significant human resources. This study introduces a framework, SAC, which focuses on 1) augmenting the representation of a claim by incorporating additional context using general-purpose, comprehensive, and authoritative data; 2) developing a search function to automatically select relevant, new, and credible references; 3) focusing on the important parts of the representations of a claim and its reference that are most relevant to the fact-checking task. The experimental results demonstrate that 1) Augmenting the representations of claims and references through the use of a knowledge base, combined with the multi-head attention technique, contributes to improved performance of fact-checking. 2) SAC with auto-selected references outperforms existing fact-checking approaches with manual selected references. Future directions of this study include I) exploring knowledge graphs in Wikidata to dynamically augment the representations of claims and references without introducing too much noise, II) exploring semantic relations in claims and references to further enhance fact-checking.

Keywords: fact checking, claim verification, deep learning, natural language processing

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Authors: Nurezlin Mohd Azib, Pan Kok Chang

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This quantitative study investigates the effects of major and minor modes, and contributing musical parameter of tempo, to the emotional perceptions of ‘happy’ and ‘sad’ in piano music among subjects aged 9-17 years old. The study was conducted in two phases; survey-questionnaire, and listening activity. Subjects (N=31) were sampled from piano music students’ population in Bangi, Selangor. In the survey-questionnaire, subjects answered 20 questions on demographic characteristics, music listening and preference, and understanding of emotional perception in music. In the listening activity, subjects listened to 20 untitled piano music excerpts and rated the emotion perceived for each excerpt, whether ‘happy’ or ‘sad’. Results from survey-questionnaire show that most percentage of subjects are 11 years old, in Grade 1, of 3 years of learning piano, prefer classical music, always listen to music, prefer both major and minor modes’ music, and find it easy to understand emotion in music, as well as major and minor modes. Results from listening activity show that 60 % of major mode music are perceived as ‘major-happy’, while 60 % too, of minor mode music are perceived as ‘minor-sad’. However, Chi-square test of independence statistical analysis indicates that there are no association and significant relationship between modes (major and minor) and ‘happy’, as well as ‘sad’ perceptions (x2 (1, N = 20) = 0.80, p = 0.371), at the significance level of p ≤ 0.05. Contrastingly, there are association and significant relationship between tempo (fast and slow), and ‘happy’, as well as ‘sad’ perceptions (x2 (1, N = 20) = 9.899, p = 0.005). Therefore, it is concluded that tempo plays an important role in effects of major and minor mode to ‘happy’ and ‘sad’ emotional perceptions in piano music among subjects aged 9 to 17 in this study.

Keywords: effects, emotional perceptions, major and minor modes, piano music

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Authors: Kayondoamunmose Kamafrika

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Experimental based Engineering education approach plays a vital role in the development of student’s deep understanding of both social and physical sciences. Experimental based education approach through laboratory class activities prepare students to meet national demand for high-tech skilled individuals in the government and private sector. However, students across the country are faced with difficulties in classes that involve laboratory activities: poor experimental based exposure in their early development of student’s education-life-cycle, lack of student engagement in scientific method practical thinking approach, lack of communication between students and the instructor during class, a large number of students in one classroom, lack of instruments and improper equipment calibration. The purpose of this paper is to help students develop their own scientific knowledge and understanding, develop their methodologies in the design of experiments, collect and analyze data, write laboratory reports, present and explain their findings. Experimental based laboratory activities allow students to learn with high-level understanding as well as engage in the design processes of constructing knowledge through practical means of doing science. Experimental based education systems approach will act as a catalyst in the development of practical-based-educational methodologies in social and physical science and engineering domain of learning; thereby, converting laboratory classes into pilot industries and students into professional experts in finding a solution for complex problems, research, and development of super high- tech systems.

Keywords: experimental, engineering, innovation, practicability

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Authors: Meryam Labyad, Karima Fakiri, Widad Lahmini, Ghizlane Draiss, Mohamed Bouskraoui, Nadia Ouzennou

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Background: Asthma is the most common chronic disease in children, affecting nearly 235 million people worldwide (OMS). In Morocco, asthma is much more common in children than in adults; the prevalence rate in children between 13 and 14 years of age is 20%.1 This pathology is marked by high morbidity, a significant impact on the quality of life and development of children 2 This requires a rigorous management strategy in order to achieve clinical control and reduce any risk to the patient 3 A search for aggravating factors is mandatory if a child has difficulty maintaining good asthma control. The objective of the present study is to describe asthma control during this confinement period in children aged 4 to 11 years followed by a pneumo-paediatric consultation. For children whose asthma is not controlled, a search for associations with promoting factors and adherence to treatment is also among the objectives of the study. Knowing the level of asthma control and influencing factors is a therapeutic priority in order to reduce hospitalizations and emergency care use. Objective: To assess asthma control and determine the factors influencing asthma levels in children with asthma during confinement following the COVID 19 pandemic. Method: Prospective cross-sectional study by questionnaire and structured interview among 66 asthmatic children followed in pediatric pneumology consultation at the CHU MED VI of Marrakech from 13/06/2020 to 13/07/2020, asthma control was assessed by the Childhood Asthma Control Test (C-ACT). Results: 66 children and their parents were included (mean age is 7.5 years), asthma was associated with allergic rhinitis (13.5% of cases), conjunctivitis (9% of cases), eczema (12% of cases), occurrence of infection (10.5% of cases). The period of confinement was marked by a decrease in the number of asthma attacks translated by a decrease in the number of emergency room visits (7.5%) of these asthmatic children, control was well controlled in 71% of the children, this control was significantly associated with good adherence to treatment (p<0.001), no infection (p<0.001) and no conjunctivitis (p=002) or rhinitis (p<0.001). This improvement in asthma control during confinement can be explained by the measures taken in the Kingdom to prevent the spread of COVID 19 (school closures, reduction in industrial activity, fewer means of transport, etc.), leading to a decrease in children's exposure to triggers, which justifies the decrease in the number of children having had an infection, allergic rhinitis or conjunctivitis during this period. In addition, the close monitoring of parents resulted in better therapeutic adherence (42.4% were fully observant). Confinement was positively perceived by 68% of the parents; this perception is significantly associated with the level of asthma control (p<0.001). Conclusion: Maintaining good control can be achieved through improved therapeutic adherence and avoidance of triggers, both of which were achieved during the containment period following the VIDOC pandemic 19.

Keywords: Asthma, control , COVID-19 , children

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Authors: L. Krpalkova, N. O' Mahony, A. Carvalho, S. Campbell, G. Corkery, E. Broderick, J. Walsh

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Farm management and operations will drastically change due to access to real-time data, real-time forecasting, and tracking of physical items in combination with Internet of Things developments to further automate farm operations. Dairy farms have embraced technological innovations and procured vast amounts of permanent data streams during the past decade; however, the integration of this information to improve the whole farm-based management and decision-making does not exist. It is now imperative to develop a system that can collect, integrate, manage, and analyse on-farm and off-farm data in real-time for practical and relevant environmental and economic actions. The developed systems, based on machine learning and artificial intelligence, need to be connected for useful output, a better understanding of the whole farming issue, and environmental impact. Evolutionary computing can be very effective in finding the optimal combination of sets of some objects and, finally, in strategy determination. The system of the future should be able to manage the dairy farm as well as an experienced dairy farm manager with a team of the best agricultural advisors. All these changes should bring resilience and sustainability to dairy farming as well as improving and maintaining good animal welfare and the quality of dairy products. This review aims to provide an insight into the state-of-the-art of big data applications and evolutionary computing in relation to smart dairy farming and identify the most important research and development challenges to be addressed in the future. Smart dairy farming influences every area of management, and its uptake has become a continuing trend.

Keywords: big data, evolutionary computing, cloud, precision technologies

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Authors: Sophia Anastasiou, Cosmas Nathanailides, Fotini Kakali, Kostas Karipoglou

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Wild fish are considered as testier and in fish restaurants are offered at twice the price of farmed fish. Several chemical and structural differences can affect the consumer's attitudes for farmed fish. The structure and chemical composition of fish muscle is also important for the performance of farmed fish during handling, storage and processing. In the present work we present the chemical and sensory parameters which are used as indicators of fish flesh quality and we investigated the perceptions of consumers for farmed sea bass and the organoleptic differences between samples of wild and farmed sea bass. A questionnaire was distributed to a group of various ages that were regular consumers of sea bass. The questionnaire included a survey on the perceptions on taste and appearance differences between wild and farmed sea bass. A significant percentage (>40%) of the participants stated their perception of superior taste of wild sea bass versus the farmed fish. The participants took part in an organoleptic assessment of wild and farmed sea bass prepared and cooked by a local fish restaurant. Portions were evaluated for intensity of sensorial attributes from 1 (low intensity) to 5 (high intensity). The results indicate that contrary to the assessor's perception, farmed sea bass scored better in al organoleptic parameters assessed with marked superiority in texture and taste over the wild sea bass. This research has been co-financed by the European Union (European Social Fund – ESF) and Greek national funds through the Operational Program "Education and Lifelong Learning" of the National Strategic Reference Framework (NSRF) - Research Funding Program: ARCHIMEDES III. Investing in knowledge society through the European Social Fund.

Keywords: fish marketing, farmed fish, seafood quality, wild fish

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Authors: Ç. Gökçek-Saraç, Ş. Özen, N. Derin

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The N-methyl-D-aspartate (NMDA)-dependent pathway is the major intracellular signaling pathway implemented in both short- and long-term memory formation in the hippocampus which is the most studied brain structure because of its well documented role in learning and memory. However, little is known about the effects of RF-EMR exposure on NMDA receptor signaling pathway including activation of protein kinases, notably Ca²⁺/calmodulin-dependent protein kinase II alpha (CaMKIIα). The aim of the present study was to investigate the effects of acute and chronic 900 MHz RF-EMR exposure on both passive avoidance behaviour and hippocampal levels of CaMKIIα and its phosphorylated form (pCaMKIIα). Rats were divided into the following groups: Sham rats, and rats exposed to 900 MHz RF-EMR for 2 h/day for 1 week (acute group) or 10 weeks (chronic group), respectively. Passive avoidance task was used as a behavioural method. The hippocampal levels of selected kinases were measured using Western Blotting technique. The results of passive avoidance task showed that both acute and chronic exposure to 900 MHz RF-EMR can impair passive avoidance behaviour with minor effects on chronic group of rats. The analysis of western blot data of selected protein kinases demonstrated that hippocampal levels of CaMKIIα and pCaMKIIα were significantly higher in chronic group of rats as compared to acute groups. Taken together, these findings demonstrated that different duration times (1 week vs 10 weeks) of 900 MHz RF-EMR exposure have different effects on both passive avoidance behaviour of rats and hippocampal levels of selected protein kinases.

Keywords: hippocampus, protein kinase, rat, RF-EMR

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Authors: Denise Levy

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Nuclear technology is part of our everyday life and its beneficial applications help to improve the quality of our lives. Nevertheless, in Brazil, most often the media and social networks tend to associate radiation to nuclear weapons and major accidents, and there is still great misunderstanding about the peaceful applications of nuclear science. The Educational Portal Radioatividades (Radioactivities) is a corporate social responsibility initiative that takes advantage of the growing impact of Internet to offer high quality scientific information for teachers and students throughout Brazil. This web-based initiative focusses on the positive applications of nuclear technology, presenting the several contributions of ionizing radiation in different contexts, such as nuclear medicine, agriculture techniques, food safety and electric power generation, proving nuclear technology as part of modern life and a must to improve the quality of our lifestyle. This educational project aims to contribute for democratization of scientific education and social inclusion, approaching society to scientific knowledge, promoting critical thinking and inspiring further reflections. The website offers a wide variety of ludic activities such as curiosities, interactive exercises and short courses. Moreover, teachers are offered free web-based material with full instructions to be developed in class. Since year 2013, the project has been developed and improved according to a comprehensive study about the realistic scenario of ICTs infrastructure in Brazilian schools and in full compliance with the best e-learning national and international recommendations.

Keywords: information and communication technologies, nuclear technology, science communication, society and education

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Authors: Martyna Chotomska, Aleksandra Studzinska, Marta Lisowska, Justyna Szubert, Aleksandra Tabis, Jacek Bania, Arkadiusz Miazek

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Objectives: Assessing antigen-specific T cell responses is of utmost importance for the pre-clinical testing of prototype vaccines against intracellular pathogens and tumor antigens. Mainly two types of in vitro assays are used for this purpose 1) enzyme-linked immunospot (ELISpot) and 2) intracellular cytokine staining (ICS). Both are time-consuming, relatively expensive, and require manual dexterity. Here, we assess if a straightforward detection of luciferase activity in blood samples of transgenic reporter mice expressing a secreted Lucia luciferase under the transcriptional control of IFN-γ promoter parallels the sensitivity of IFNγ ELISpot assay. Methods: IFN-γ-LUCIA mouse strain carrying multiple copies of Lucia luciferase transgene under the transcriptional control of IFNγ minimal promoter were generated by pronuclear injection of linear DNA. The specificity of transgene expression and mobilization was assessed in vitro using transgenic splenocytes exposed to various mitogens. The IFN-γ-LUCIA mice were immunized with 50mg of ovalbumin (OVA) emulsified in incomplete Freund’s adjuvant three times every two weeks by subcutaneous injections. Blood samples were collected before and five days after each immunization. Luciferase activity was assessed in blood serum. Peripheral blood mononuclear cells were separated and assessed for frequencies of OVA-specific IFNγ-secreting T cells. Results: We show that in vitro cultured splenocytes of IFN-γ-LUCIA mice respond by 2 and 3 fold increase in secreted luciferase activity to T cell mitogens concanavalin A and phorbol myristate acetate, respectively but fail to respond to B cell-stimulating E.coli lipopolysaccharide. Immunization of IFN-γ-LUCIA mice with OVA leads to over 4 fold increase in luciferase activity in blood serum five days post-immunization with a barely detectable increase in OVA-specific, IFNγ-secreting T cells by ELISpot. Second and third immunizations, further increase the luciferase activity and coincidently also increase the frequencies of OVA-specific T cells by ELISpot. Conclusions: We conclude that minimally invasive monitoring of luciferase secretions in blood serum of IFN-γ-LUCIA mice constitutes a sensitive method for evaluating primary and memory Th1 responses to protein antigens. As such, this method may complement existing methods for rapid immunogenicity assessment of prototype vaccines.

Keywords: ELISpot, immunogenicity, interferon-gamma, reporter mice, vaccines

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Authors: Ervin Meqikukiqi

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It is difficult to assess how athletes can best modify their movements to prevent non contact ACL injuries. Speaking with an athletic trainer, physical therapist, or sports medicine specialist is a good place to start. Recent research has allowed therapists and clinicians to easily identify and target weak muscle areas (e.g., weak hips, which leads to knock-kneed landing positions) and identify ways to improve strength and thus help prevent injury. In addition, other risk factors such as reduced hamstring strength and increased joint range of motion can be further assessed by a physical therapist or athletic trainer to improve performance-or rehabilitation efforts after an injury has occurred. Current studies also demonstrate that specific types of training, such as jump routines and learning to pivot properly, help athletes prevent ACL injuries. These types of exercises and training programs are more beneficial if athletes start when they are young. It may be optimal to integrate prevention programs during early adolescence, prior to when young athletes develop certain habits that increase the risk of an ACL injury. This is a 20 minute program designed to reduce the risk of tears of the Anterior Cruciate Ligament. It should be started at least four and preferably six weeks prior to start of competition.Ideally it is done five times per week preseason and three times per week in season.The coach or trainer must constantly observe athletes during these exercises to correct and maintain proper technique. Once the athletes understand the principles, they can monitor and coach each other. Four phases: Warm-up, Strengthening, Plyometrics, Agility and Balance.

Keywords: athletes, acl, prevention, injuries, plyoemtric, proprioception, agillity

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Authors: Ofelia Loani Elvir Lazo, Roya Yumul, David Chernobylsky, Omar Durra

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Background: It is crucial to detect the patient’s existing anxiety to assist patients in a perioperative setting which is to be caused by the fear associated with surgical and anesthetic complications. However, the current gold standard for assessing patient anxiety, the STAI, is problematic to use in the preoperative setting, given the duration and concentration required to complete the 40-item questionnaire. Our primary aim in the study is to investigate the correlation of the Yumul Visual Facial Anxiety Scale (VFAS) and Numerical Verbal Rating Scale (NVRS) to State-Trait Anxiety Inventory (STAI) to determine the optimal anxiety scale to use in the perioperative setting. Methods: A clinical study of patients undergoing various surgeries was conducted utilizing each of the preoperative anxiety scales. Inclusion criteria included patients undergoing elective surgeries, while exclusion criteria included patients with anesthesia contraindications, inability to comprehend instructions, impaired judgement, substance abuse history, and those pregnant or lactating. 293 patients were analyzed in terms of demographics, anxiety scale survey results, and anesthesia data via Spearman Coefficients, Chi-Squared Analysis, and Fischer’s exact test utilized for comparative analysis. Results: Statistical analysis showed that VFAS had a higher correlation to STAI than NVRS (rs=0.66, p<0.0001 vs. rs=0.64, p<0.0001). The combined VFAS-Categorization Scores showed the highest correlation with the gold standard (rs=0.72, p<0.0001). Subgroup analysis showed similar results. STAI evaluation time (247.7 ± 54.81 sec) far exceeds VFAS (7.29 ± 1.61 sec), NVRS (7.23 ± 1.60 sec), and Categorization scales (7.29 ± 1.99 sec). Patients preferred VFAS (54.4%), Categorization (11.6%), and NVRS (8.8%). Anesthesiologists preferred VFAS (63.9%), NVRS (22.1%), and Categorization Scales (14.0%). Of note, the top five causes of preoperative anxiety were determined to be waiting (56.5%), pain (42.5%), family concerns (40.5%), no information about surgery (40.1%), or anesthesia (31.6%). Conclusıons: Both VFAS and Categorization tests also take significantly less time than STAI, which is critical in the preoperative setting. Combined VFAS-Categorization Score (VCS) demonstrates the highest correlation to the gold standard, STAI. Among both patients and anesthesiologists, VFAS was the most preferred scale. This forms the basis of the Yumul Faces Anxiety Scale, designed for quick quantization and assessment in the preoperative setting while maintaining a high correlation to the golden standard. Additional studies using the formulated Yumul Faces Anxiety Scale are merited.

Keywords: numerical verbal anxiety scale, preoperative anxiety, state-trait anxiety inventory, visual facial anxiety scale

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Authors: Muhammad Qamar Masood, Syed Abbas Raza, Umar Yousaf Raja, Imran Hassan, Bilal Afzal, Muhammad Aleem Zahir, Atika Shaheer

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Background: Cardiovascular disease (CVD) is a major burden among people with type 2 diabetes (T2D) with 1 in 3 reported to have CVD. Therefore, understanding real-world clinical characteristics and prescribing patterns could help in better care. Objective: The CONVERGE (Cardiovascular Outcomes and Value in the Real world with GLP-1RAs) study characterized demographics and medication usage patterns in T2D intensified (add-on to metformin) overall population. The data were further divided into subgroups {dipeptidyl peptidase-4 inhibitors (DPP-4is), sulfonylureas (SUs), insulins, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT-2is)}, according to the latest prescribed antidiabetic agent (ADA) in India/Pakistan/Thailand. Here, we report findings from Pakistan. Methods: A multi-center retrospective study utilized data from medical records between 13-Sep-2008 (post-market approval of GLP-1RAs) and 31-Dec-2017 in adults (≥18-year-old). The data for this study were collected from 05 centers / institutes located in major cities of Pakistan, including Karachi, Lahore, Islamabad, and Multan. These centers included National Hospital, Aga Khan University Hospital, Diabetes Endocrine Clinic Lahore, Shifa International Hospital, Mukhtar A Sheikh Hospital Multan. Data were collected at start of medical record and at 6 or 12-months prior to baseline based on variable type; analyzed descriptively. Results: Overall, 1,010 patients were eligible. At baseline, overall mean age (SD) was 51.6 (11.3) years, T2D duration was 2.4 (2.6) years, HbA1c was 8.3% (1.9) and 35% received ≥1CVD medications in the past 1-year (before baseline). Most frequently prescribed ADAs post-metformin were DPP-4is and SUs (~63%). Only 6.5% received GLP-1RAs and SGLT-2is were not available in Pakistan during the study period. Overall, it took a mean of 4.4 years and 5 years to initiate GLP-1RAs and SGLT-2is, respectively. In comparison to other subgroups, more patients from GLP-1RAs received ≥3 types of ADA (58%), ≥1 CVD medication (64%) and had higher body mass index (37kg/m2). Conclusions: Utilization of GLP-1RAs and SGLT-2is was low, took longer time to initiate and not before trying multiple ADAs. This may be due to lack of evidence for CV benefits for these agents during the study period. The planned phase 2 of the CONVERGE study can provide more insights into utilization and barriers to prescribe GLP-1RAs and SGLT-2is post 2018 in Pakistan.

Keywords: type 2 diabetes, GLP-1RA, treatment intensification, cardiovascular disease

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Authors: Garima Joshi, Pratap Sharan, V. Sreenivas, Nand Kumar, Kameshwar Prasad, Ashima N. Wadhawan

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Schizophrenia is a debilitating disorder and is marked by cognitive impairment, which deleteriously impacts the social and professional functioning along with the quality of life of the patients and the caregivers. Often the cognitive symptoms are in their prodromal state and worsen as the illness progresses; they have proven to have a good predictive value for the prognosis of the illness. It has been shown that intensive cognitive rehabilitation (CR) leads to improvements in the healthy as well as cognitively-impaired subjects. As the majority of population in India falls in the lower to middle socio-economic status and have low education levels, using the existing packages, a majority of which are developed in the West, for cognitive rehabilitation becomes difficult. The use of technology is also restricted due to the high costs involved and the limited availability and familiarity with computers and other devices, which pose as an impedance for continued therapy. Cognitive rehabilitation in India uses a plethora of retraining methods for the patients with schizophrenia targeting the functions of attention, information processing, executive functions, learning and memory, and comprehension along with Social Cognition. Psychologists often have to follow an integrative therapy approach involving social skills training, family therapy and psychoeducation in order to maintain the gains from the cognitive rehabilitation in the long run. This paper reviews the methodologies and cognitive retaining programs used in India. It attempts to elucidate the evolution and development of methodologies used, from traditional paper-pencil based retraining to more sophisticated neuroscience-informed techniques in cognitive rehabilitation of deficits in schizophrenia as home-based or supervised and guided programs for cognitive rehabilitation.

Keywords: schizophrenia, cognitive rehabilitation, neuropsychological interventions, integrated approached to rehabilitation

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Authors: Leonardo C. Pacheco-Londoño, Nataly J Galan-Freyle, Lisandro Pacheco-Lugo, Antonio Acosta-Hoyos, Elkin Navarro, Gustavo Aroca-Martinez, Karin Rondón-Payares, Alberto C. Espinosa-Garavito, Samuel P. Hernández-Rivera

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At the Life Science Research Center at Simon Bolivar University, a primary focus is the diagnosis of various diseases, and the use of gold nanoparticles (Au-NPs) in diverse biomedical applications is continually expanding. In the present study, Au-NPs were employed as substrates for Surface-Enhanced Raman Spectroscopy (SERS) aimed at diagnosing kidney diseases arising from Lupus Nephritis (LN), preeclampsia (PC), and Hypertension (H). Discrimination models were developed for distinguishing patients with and without kidney diseases based on the SERS signals from urine samples by partial least squares-discriminant analysis (PLS-DA). A comparative study of the Raman signals across the three conditions was conducted, leading to the identification of potential metabolite signals. Model performance was assessed through cross-validation and external validation, determining parameters like sensitivity and specificity. Additionally, a secondary analysis was performed using machine learning (ML) models, wherein different ML algorithms were evaluated for their efficiency. Models’ validation was carried out using cross-validation and external validation, and other parameters were determined, such as sensitivity and specificity; the models showed average values of 0.9 for both parameters. Additionally, it is not possible to highlight this collaborative effort involved two university research centers and two healthcare institutions, ensuring ethical treatment and informed consent of patient samples.

Keywords: SERS, Raman, PLS-DA, kidney diseases

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Authors: Tsoaledi D. Thobejane, Barnabas C. Okere

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Gender mainstreaming has been adopted as a strategy for promoting gender equality in institutions of higher learning Worldwide, not least in Africa. This study investigated Gender Mainstreaming at the University of Venda, in Limpopo Province, South Africa. The study was based on the Feminist Theoretical Framework. Both qualitative and quantitative approaches were used. A case study research design was adopted. The study involved a population of 60 participants and a sample of 25 male and female workers selected using the purposive sampling technique. Data were presented in pie charts, tables, themes and in textual forms. Data were analysed through descriptive statistics and thematic analysis. The major findings and conclusions of the study were that the University of Venda faces enormous challenges in mainstreaming gender in the university functions. There are perceptions that most strategic higher positions in the institution are dominated by men while women are marginalized. Although the University has policies on gender, staff members do not know about them while management does not implement its policies. University of Venda makes use of the Employment Equity Act of 1998, but it is not clear whether line managers are aware of its implementation and how. In addition, favouritism, nepotism, patronage, and patriarchy played a role in gender mainstreaming. The study recommended that there should be more gender awareness activities, such as workshops, conferences, and symposia for workers and staff members in order to sensitize them about gender towards understanding. The study also recommended that deserving female staff members should be promoted, and all employees should be encouraged to read and understand gender policies. In addition, management should implement the institutions and national gender policies without fear or favour.

Keywords: gender mainstreaming, gender equality, institutions, representation

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Authors: D. Tedesco, G. Feletti, P. Trucco

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The present study aims to develop a Decision Support System (DSS) to support the operational decision of the Emergency Medical Service (EMS) regarding the assignment of medical emergency requests to Emergency Departments (ED). In the literature, this problem is also known as “hospital selection” and concerns the definition of policies for the selection of the ED to which patients who require further treatment are transported by ambulance. The employed research methodology consists of the first phase of revision of the technical-scientific literature concerning DSSs to support the EMS management and, in particular, the hospital selection decision. From the literature analysis, it emerged that current studies are mainly focused on the EMS phases related to the ambulance service and consider a process that ends when the ambulance is available after completing a request. Therefore, all the ED-related issues are excluded and considered as part of a separate process. Indeed, the most studied hospital selection policy turned out to be proximity, thus allowing to minimize the transport time and release the ambulance in the shortest possible time. The purpose of the present study consists in developing an optimization model for assigning medical emergency requests to the EDs, considering information relating to the subsequent phases of the process, such as the case-mix, the expected service throughput times, and the operational capacity of different EDs in hospitals. To this end, a Discrete Event Simulation (DES) model was created to evaluate different hospital selection policies. Therefore, the next steps of the research consisted of the development of a general simulation architecture, its implementation in the AnyLogic software and its validation on a realistic dataset. The hospital selection policy that produced the best results was the minimization of the Time To Provider (TTP), considered as the time from the beginning of the ambulance journey to the ED at the beginning of the clinical evaluation by the doctor. Finally, two approaches were further compared: a static approach, which is based on a retrospective estimate of the TTP, and a dynamic approach, which is based on a predictive estimate of the TTP determined with a constantly updated Winters model. Findings reveal that considering the minimization of TTP as a hospital selection policy raises several benefits. It allows to significantly reduce service throughput times in the ED with a minimum increase in travel time. Furthermore, an immediate view of the saturation state of the ED is produced and the case-mix present in the ED structures (i.e., the different triage codes) is considered, as different severity codes correspond to different service throughput times. Besides, the use of a predictive approach is certainly more reliable in terms of TTP estimation than a retrospective approach but entails a more difficult application. These considerations can support decision-makers in introducing different hospital selection policies to enhance EMSs performance.

Keywords: discrete event simulation, emergency medical services, forecast model, hospital selection

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