Search results for: digital medical education

Authors: Amy L. Smith

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This study investigates the impact of student authenticity while engaging in academic exploration of students' sense of belonging, autonomy, and persistence. Research questions include: How does incorporating authenticity in first-year academic exploration courses impact; 1) first-year students’ sense of belonging, autonomy, and persistence? 2) first-year students’ sense of belonging, autonomy, and persistence during the first and last halves of the fall semester? 3) first-year students’ sense of belonging, autonomy, and persistence among various student demographics? First-year students completed a Likert-like survey at the conclusion of eight weeks (first and last eight weeks/fall semester) academic exploration courses. Course redesign included grounding the curriculum and instruction with student authenticity and creating opportunities for students to explore, define, and reflect upon their authenticity during academic exploration. Surveys were administered at the conclusion of these eight week courses (first and last eight weeks/fall semester). Data analysis included an entropy balancing matching method and t-tests. Research findings indicate integrating authenticity into academic exploration courses for first-year students has a positive impact on students' autonomy and persistence. There is a significant difference between authenticity and first-year students' autonomy (p = 0.00) and persistence (p = 0.01). Academic exploration courses with the underpinnings of authenticity are more effective in the second half of the fall semester. There is a significant difference between an academic exploration course grounding the curriculum and instruction in authenticity offered M8A (first half, fall semester) and M8B (second half, fall semester) (p = 0); M8B courses illustrate an increase of students' sense of belonging, autonomy, and persistence. Integrating authenticity into academic exploration courses for first-year students has a positive impact on varying student demographics (p = 0.00). There is a significant difference between authenticity and low-income (p = 0.04), first-generation (p = 0.00), Caucasian (p = 0.02), and American Indian/Alaskan Native (p = 0.05) first-year students' sense of belonging, autonomy, and persistence. Academic exploration courses embedded in authenticity helps develop first-year students’ sense of belonging, autonomy, and persistence, which are effective traits of college students. As first-year students engage in content courses, professors can empower students to have greater engagement in their learning process by relating content to students' authenticity and helping students think critically about how content is authentic to them — how students' authenticity relates to the content, how students can take their content expertise into the future in ways that, to the student, authentically contribute to the greater good. A broader conversation within higher education needs to include 1) designing courses that allow students to develop and reflect upon their authenticity/to formulate answers to the questions: who am I, who am I becoming, and how will I move my authentic self forward; and 2) a discussion of how to shift from the university shaping students to the university facilitating the process of students shaping themselves.

Keywords: authenticity, first-year experience, sense of belonging, autonomy, persistence

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Authors: Marian Emmanuel Okon

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Introduction: The Niger Delta region of Nigeria has a vast reserve of oil and gas, which has globally positioned the nation as the sixth largest exporter of crude oil. Production rapidly rose following oil discovery. In most oil producing nations of the world, the wealth generated from oil production and export has propelled economic advancement, enabling the development of industries and other relevant infrastructures. Therefore, it can be assumed that majority of the oil resource such as Nigeria’s, has the potential to improve the health of the population via job creation and derived revenues. However, the health benefits of this economic development might be offset by the environmental consequences of oil exploitation and production. Objective: This research aims to evaluate the balance between the health benefits of oil-led economic development and harmful environmental consequences of crude oil exploitation in Nigeria. Study Design: A pathway has been designed to guide data search and this study. The model created will assess the relationship between oil-led economic development and population health development via job creation, improvement of education, development of infrastructure and other forms of development as well as through harmful environmental consequences from oil activities. Data/Emerging Findings: Diverse potentially suitable datasets which are at different geographical scales have been identified, obtained or applied for and the dataset from the World Bank has been the most thoroughly explored. This large dataset contains information that would enable the longitudinal assessment of both the health benefits and harms from oil exploitation in Nigeria as well as identify the disparities that exist between the communities, states and regions. However, these data do not extend far back enough in time to capture the start of crude oil production. Thus, it is possible that the maximum economic benefits and health harms could be missed. To deal with this shortcoming, the potential for a comparative study with countries like United Kingdom, Morocco and Cote D’ivoire has also been taken into consideration, so as to evaluate the differences between these countries as well as identify the areas of improvement in Nigeria’s environmental and health policies. Notwithstanding, these data have shown some differences in each country’s economic, environmental and health state over time as well as a corresponding summary statistics. Conclusion: In theory, the beneficial effects of oil exploitation to the health of the population may be substantial as large swaths of the ‘wider determinants’ of population heath are influenced by the wealth of a nation. However, if uncontrolled, the consequences from environmental pollution and degradation may outweigh these benefits. Thus, there is a need to address this, in order to improve environmental and population health in Nigeria.

Keywords: environmental pollution, health benefits, oil-led economic development, petroleum exploitation

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Authors: María de los Ángeles Cerda González, Itzel Arriaga Hurtado, Pascacio José Martínez Pichardo

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In México, the recognition of refugee condition is a fundamental right which, as host State, has the obligation of respect, protect, and fulfill to the foreigners – where we can find the figure of immigrants in irregular situation-, that cannot return to their country of origin for humanitarian reasons. The recognition of the refugee condition as a fundamental right in the Mexican law system proceeds under these situations: 1. The immigrant applies for the refugee condition, even without the necessary proving elements to accredit the humanitarian character of his departure from his country of origin. 2. The immigrant does not apply for the recognition of refugee because he does not know he has the right to, even if he has the profile to apply for. 3. The immigrant who applies fulfills the requirements of the administrative procedure and has access to the refugee recognition. Of the three situations above, only the last one is contemplated for the national indexes of the status refugee; and the first two prove the inefficiency of the governmental system viewed from its lack of sensibility consequence of the no education in human rights matter and which results in the legal vulnerability of the immigrants in irregular situation because they do not have access to the procuration and administration of justice. In the aim of determining the causes and consequences of the no recognition of the refugee status, this investigation was structured from a systemic analysis which objective is to show the advances in Central American humanitarian emergency investigation, the Mexican States actions to protect, respect and fulfil the fundamental right of refugee of immigrants in irregular situation and the social and legal vulnerabilities suffered by Central Americans in Mexico. Therefore, to achieve the deduction of the legal nature of the humanitarian emergency from the Human Rights as a branch of the International Public Law, a conceptual framework is structured using the inductive deductive method. The problem statement is made from a legal framework to approach a theoretical scheme under the theory of social systems, from the analysis of the lack of communication of the governmental and normative subsystems of the Mexican legal system relative to the process undertaken by the Central American immigrants to achieve the recognition of the refugee status as a human right. Accordingly, is determined that fulfilling the obligations of the State referent to grant the right of the recognition of the refugee condition, would mean a guideline for a new stage in Mexican Law, because it would enlarge the constitutional benefits to everyone whose right to the recognition of refugee has been denied an as consequence, a great advance in human rights matter would be achieved.

Keywords: central American immigrants in irregular situation, humanitarian emergency, human rights, refugee

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Authors: Mykah W. Sumoldao, Maria Erissa C. Susa, Triny Cate M. Telan, Christian Arvin M. Torres, Jasmine I. Udasco, Franceis Jeramil M. Walis, Shellyn S. Wandagan, Janine May M. Warding, Queenie Diana Rose P. Zalun Hope Lulet A. Lomioan

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This descriptive phenomenological study explored the lived experiences of the primary caregiver of schizophrenia patients at the Acute Crisis Intervention Service in Cagayan Valley Medical Center. The research aimed to understand the emotional, physical, and financial challenges these primary caregivers face. Data was gathered through interviews with nine (9) primary caregivers and analyzed using Colaizzi’s seven-step method. Two main themes emerged: Experience/ Challenges (Emotional, Physical, and Financial Challenges) and Managing Mechanisms (Support Systems and Resilience and Commitment). The study found that primary caregivers deal with a complex mix of difficulties, often with limited resources. They rely heavily on personal strength, faith, family, friends and community support to manage their roles. The findings highlighted the need for better support systems to ease primary caregivers' burdens. Financial aid, respite care, and mental health support are crucial for improving primary caregivers' quality of life and the care they provide. Additionally, raising awareness about primary caregivers' challenges can foster a supportive community, with more help from local organizations and government entities. Thus, this study provided insights into the caregiving experiences of those supporting schizophrenia patients. It emphasized the importance of practical support and emotional resilience. By addressing these needs, a more supportive environment can be created, benefiting both primary caregivers and their patients.

Keywords: primary caregiver burden, mental health, primary caregiver well-being, primary caregiver

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Authors: Alice D. Dioquino, Olivia N. Buzon, Emilio F. Aguinaldo, Ruel Avila, Erwin R. Callo, Cristy Ocampo, Malvin R. Tabajen, Marla C. Papango, Marilou M. Ubina, Josephine Tondo, Cromwell L. Valeriano

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The main purpose of this study was to develop, evaluate and validate courseware on Selected Topics in Mathematics, Science, and the English Language. Specifically, it aimed to: 1. Identify the appropriate Instructional Systems Design (ISD) model in the development of the courseware material; 2. Assess the courseware material according to its: a. Content Characteristics; b. Instructional Characteristics; and c. Technical Characteristics 3. Find out if there is a significant difference in the performance of students before and after using the tutorial CAI. This research is developmental as well as a one group pretest-posttest design. The study had two phases. Phase I includes the needs analysis, writing of lessons and storyboard by the respective experts in each field. Phase II includes the digitization or the actual development of the courseware by the faculty of the ICT department. In this phase it adapted an instructional systems design (ISD) model which is the ADDIE model. ADDIE stands for Analysis, Design, Development, Implementation and Evaluation. Formative evaluation was conducted simultaneously with the different phases to detect and remedy any bugs in the courseware along the areas of content, instructional and technical characteristics. The expected output are the digitized lessons in Algebra, Biology, Chemistry, Physics and Communication Arts in English. Students and some IT experts validated the CAI material using the Evaluation Form by Wong & Wong. They validated the CAI materials as Highly Acceptable with an overall mean rating of 4.527and standard deviation of 0 which means that they were one in the ratings they have given the CAI materials. A mean gain was recorded and computing the t-test for dependent samples it showed that there were significant differences in the mean achievement of the students before and after the treatment (using CAI). The identified ISD model used in the development of the tutorial courseware was the ADDIE model. The quantitative analyses of data based on ratings given by the respondents’ shows that the tutorial courseware possess the characteristics and or qualities of a very good computer-based courseware. The ratings given by the different evaluators with regard to content, instructional, and technical aspects of the Tutorial Courseware are in conformity towards being excellent. Students performed better in mathematics, biology chemistry, physics and the English Communication Arts after they were exposed to the tutorial courseware.

Keywords: CAI, tutorial courseware, Instructional Systems Design (ISD) Model, education

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Authors: Renee Fabian, Jordan Davidson

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Current research on non-suicidal self-injury (NSSI) provides ample insights on best practices for caregivers and clinicians to address and reduce NSSI behavior among adolescents. However, the efficacy of evidenced-based NSSI interventions and their delivery from the perspective of adolescent patients does not receive significant attention, creating a gap between the efficacy of research-based NSSI interventions and adolescent perceptions of NSSI treatment and adolescent willingness to engage in NSSI interventions. To address the gap between practice and patient perspectives and inform more effective treatment outcomes, the current survey aims to identify major patient-reported adverse reactions to NSSI disclosures from caregivers, treating mental health clinicians, and medical professionals using a mixed methods survey of 2,500 people with a history of NSSI completed by editors at a consumer-facing health publication. Based on the analyzed results of the survey, a majority of adolescents with a history of NSSI found parents and caregivers ineffective at empathetically addressing NSSI, and a significant number of participants reported at least one treating mental health professional inadequately responded to NSSI behaviors, in addition to other findings of adverse reactions to NSSI disclosures that serve as a barrier to treatment. NSSI is a significant risk factor for future suicide attempts. Addressing patient-reported adverse reactions to NSSI disclosures in the adolescent population can remove barriers to the effectiveness of caregiver and clinician NSSI interventions and reduce the risk of NSSI-related harm and lower the risk of future suicide attempts or completions.

Keywords: adolescent self-injury, non-suicidal self-injury, patient perspectives, self-harm interventions

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Authors: H.C. Chen, S. W. C. Chan, K. Cheng, A. Vathsala, H. K. Sran, H. He

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Background: End-stage renal disease (ESRD) is the last stage of chronic kidney disease. The numbers of patients with ESRD have increased worldwide due to the growing number of aging, diabetes and hypertension populations. Patients with ESRD suffer from physical illness and psychological distress due to complex treatment regimens, which often affect the patients’ social and psychological functioning. As a result, the patients may fail to perform daily self-care and self-management, and consequently experience worsening conditions. Aims: The study aims to examine the effectiveness of a self-efficacy psychoeducational programme on primary outcome (self-efficacy) and secondary outcomes (psychological wellbeing, treatment adherence, and quality of life) in patients with ESRD and haemodialysis in Singapore. Methodology: A randomised controlled, two-group pretest and repeated posttests design will be carried out. A total of 154 participants (n=154) will be recruited. The participants in the control group will receive a routine treatment. The participants in the intervention group will receive a self-efficacy psychoeducational programme in addition to the routine treatment. The programme is a two-session of educational intervention in a week. A booklet, two consecutive sessions of face-to-face individual education, and an abdominal breathing exercise are adopted in the programme. Outcome measurements include Dialysis Specific Self-efficacy Scale, Kidney Disease Quality of Life- 36 Hospital Anxiety and Depression Scale, Renal Adherence Attitudes Questionnaire and Renal Adherence Behaviour Questionnaire. The questionnaires will be used to measure at baseline, 1- and 3- and 6-month follow-up periods. Process evaluation will be conducted with a semi-structured face to face interview. Quantitative data will be analysed using SPSS21.0 software. Qualitative data will be analysed by content analysis. Significance of the study: This study will identify a clinically useful and potentially effective approach to help patients with end-stage renal disease and haemodialysis by enhancing their self-efficacy in self-care behaviour, and therefore improving their psychological wellbeing, treatment adherence and quality of life. This study will provide information to develop clinical guidelines to improve patients’ disease self-management and to enhance health-related outcomes. Hopefully it will help reducing disease burden.

Keywords: end-stage renal disease (ESRD), haemodialysis, psychoeducation, self-efficacy

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Authors: Lo Kai Chung

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Fathers in the family of disabled children play a crucial role in fostering child development. Previous studies addressing emotions of father involvement in rearing children with special needs have been rare. With reference to the cultural orientation and masculine idea of Chinese fathers, shame and guilt are probable causal emotions that affect fathers’ psycho-behavioral reactions and, thus, father involvement. Based on the findings of our earlier qualitative studies, the current study aims to develop and validate a multi-item scale of guilt or shame and explore their relations with and fatherhood in families with children with special needs. A model is proposed to understand the roles that shame and guilt play in affecting fathers’ involvement in their family system. The severity and type of the child’s special needs are regarded as independent variables affecting the father’s emotional responses – shame and guilt. It is hypothesized that shame and guilt, under the influence of masculinity, lead to avoidance and compensation, respectively, which subsequently decrease and increase father involvement with children with special needs. A cross-sectional online questionnaire survey of fathers with children with special needs recruited by convenience sampling was conducted. Potential participants were reached by bulk emails, related groups on the Internet and education/social services providers. Totally 537 valid sets of online questionnaires were collected from fathers of children with special needs. EFA on the items pool of shame and guilt was performed, resulting in an x-item single-factor solution and y-item single-factor solution, respectively. Further path model analysis revealed that shame and guilt, under the influence of masculinity, showed differential avoidance and compensation responses and resulted in a decrease and increase in father involvement with special needs children. Demographic and key confounding variables were controlled in the analysis. The shame and guilt scales developed show good psychometric properties. Furthermore, they showed significant differential impacts, under the influence of masculinity, on avoidance and compensation behaviours, consequently resulting in a decrease/increase in father involvement in the expected directions. The findings have important theoretical and practical implications. At the community and policy level, the findings inform the design of strategies for strengthening the role of men in families with special needs children.

Keywords: emotions, father involvement, guilt, shame, special needs

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Authors: Swati Kapoor, Rajeev Upreti, Monica Mahajan, Abhaya Indrayan, Dinesh Srivastava

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Enteric Fever is caused by gram negative bacilli Salmonella typhi and paratyphi. It is associated with high morbidity and mortality worldwide. Timely initiation of treatment is a crucial step for prevention of any complications. Cultures of body fluids are diagnostic, but not always conclusive or practically feasible in most centers. Moreover, the results of cultures delay the treatment initiation. Serological tests lack diagnostic value. The blood counts can offer a promising option in diagnosis. A retrospective study to find out the relevance of leucopenia and eosinopenia was conducted on 203 culture proven enteric fever patients and 159 culture proven non-enteric fever patients in a tertiary care hospital in New Delhi. The patient details were retrieved from the electronic medical records section of the hospital. Absolute eosinopenia was considered as absolute eosinophil count (AEC) of less than 40/mm³ (normal level: 40-400/mm³) using LH-750 Beckman Coulter Automated machine. Leucopoenia was defined as total leucocyte count (TLC) of less than 4 X 10⁹/l. Blood cultures were done using BacT/ALERT FA plus automated blood culture system before first antibiotic dose was given. Case and control groups were compared using Pearson Chi square test. It was observed that absolute eosinophil count (AEC) of 0-19/mm³ was a significant finding (p < 0.001) in enteric fever patients, whereas leucopenia was not a significant finding (p=0.096). Using Receiving Operating Characteristic (ROC) curves, it was observed that patients with both AEC < 14/mm³ and TCL < 8 x 10⁹/l had 95.6% chance of being diagnosed as enteric fever and only 4.4% chance of being diagnosed as non-enteric fever. This result was highly significant with p < 0.001. This is a very useful association of AEC and TLC found in enteric fever patients of this study which can be used for the early initiation of treatment in clinically suspected enteric fever patients.

Keywords: absolute eosinopenia, absolute eosinophil count, enteric fever, leucopenia, total leucocyte count

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Authors: John Ahluwalia

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As an affluent first-world nation, Canada took swift and comprehensive action during the outbreak of the SARS-CoV-2 (COVID-19) pandemic compared to other countries in the same socio-economic cohort. The United States has stumbled to overcome obstacles most developed nations have faced, which has led to significantly more per capita cases and deaths. The initial outbreaks of COVID-19 occurred in the US and Canada within days of each other and posed similar potentially catastrophic threats to public health, the economy, and governmental stability. On a macro level, events that take place in the US have a direct impact on Canada. For example, both countries tend to enter and exit economic recessions at approximately the same time, they are each other’s largest trading partners, and their currencies are inexorably linked. Variables intrinsic to Canada’s national infrastructure have been instrumental in the country’s efforts to flatten the curve of COVID-19 cases and deaths. Canada’s coordinated multi-level governmental effort has allowed it to create and enforce policies related to COVID-19 at both the national and provincial levels. Canada’s policy of universal health care is another variable. Health care and public health measures are enforced on a provincial level, and it is within each province’s jurisdiction to dictate standards for public safety based on scientific evidence. Rather than introducing confusion and the possibility of competition for resources such as PPE and vaccines, Canada’s multi-level chain of government authority has provided consistent policies supporting national public health and local delivery of medical care. This paper will demonstrate that the coordinated efforts on provincial and federal levels have been the linchpin in Canada’s relative success in containing the deadly spread of the COVID-19 virus.

Keywords: COVID-19, canada, GIS, geospatial analysis

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Authors: M. Bilal Ishfaq, Adnan N. Qureshi

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COVID-19 is the most infectious disease these days, it was first reported in Wuhan, the capital city of Hubei in China then it spread rapidly throughout the whole world. Later on 11 March 2020, the World Health Organisation (WHO) declared it a pandemic. Since COVID-19 is highly contagious, it has affected approximately 219M people worldwide and caused 4.55M deaths. It has brought the importance of accurate diagnosis of respiratory diseases such as pneumonia and COVID-19 to the forefront. In this paper, we propose a hybrid approach for the automated detection of COVID-19 using medical imaging. We have presented the hybridization of manually extracted and convolutional features. Our approach combines Haralick texture features and convolutional features extracted from chest X-rays and CT scans. We also employ a minimum redundancy maximum relevance (MRMR) feature selection algorithm to reduce computational complexity and enhance classification performance. The proposed model is evaluated on four publicly available datasets, including Chest X-ray Pneumonia, COVID-19 Pneumonia, COVID-19 CTMaster, and VinBig data. The results demonstrate high accuracy and effectiveness, with 0.9925 on the Chest X-ray pneumonia dataset, 0.9895 on the COVID-19, Pneumonia and Normal Chest X-ray dataset, 0.9806 on the Covid CTMaster dataset, and 0.9398 on the VinBig dataset. We further evaluate the effectiveness of the proposed model using ROC curves, where the AUC for the best-performing model reaches 0.96. Our proposed model provides a promising tool for the early detection and accurate diagnosis of COVID-19, which can assist healthcare professionals in making informed treatment decisions and improving patient outcomes. The results of the proposed model are quite plausible and the system can be deployed in a clinical or research setting to assist in the diagnosis of COVID-19.

Keywords: COVID-19, feature engineering, artificial neural networks, radiology images

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Authors: Joanna Błach, Anna Doś, Maria Gorczyńska, Monika Wieczorek-Kosmala

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Financial innovations can be regarded as the cause and the effect of the evolution of the financial system. Most of financial innovations are created by various financial institutions for their own purposes and needs. However, due to their diversity, financial innovations can be also applied by various business entities (other than financial institutions). This paper focuses on the potential application of financial innovations by non-financial companies. It is assumed that financial innovations may be effectively applied in all fields of corporate financial decisions integrating financial management with the risk management process. Appropriate application of financial innovations may enhance the development of the company and increase its value by improving its financial situation and reducing the level of risk. On the other hand, misused financial innovations may become the source of extra risk for the company threatening its further operation. The main objective of the paper is to identify the major types of financial innovations offered to non-financial companies by the banking system in Poland. It also aims at identifying the main factors determining the creation of financial innovations in the banking system in Poland and indicating future directions of their development. This paper consists of conceptual and empirical part. Conceptual part based on theoretical study is focused on the determinants of the process of financial innovations and their application by the non-financial companies. Theoretical study is followed by the empirical research based on the analysis of the actual offer of the 20 biggest banks operating in Poland with regard to financial innovations offered to SMEs and large corporations. These innovations are classified according to the main functions of the integrated financial management, such as: Financing, investment, working capital management and risk management. Empirical study has proved that the biggest banks operating in the Polish market offer to their business customers many types and classes of financial innovations. This offer appears vast and adequate to the needs and purposes of the Polish non-financial companies. It was observed that financial innovations pertained to financing decisions dominate in the banks’ offer. However, due to high diversification of the offered financial innovations, business customers may effectively apply them in all fields and areas of integrated financial management. It should be underlined, that the banks’ offer is highly dispersed, which may limit the implementation of financial innovations in the corporate finance. It would be also recommended for the banks operating in the Polish market to intensify the education campaign aiming at increasing knowledge about financial innovations among business customers.

Keywords: banking products and services, banking sector in Poland, corporate financial management, financial innovations, theory of innovation

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Authors: Areti Angeliki Veroniki, Sofia Tsokani, Evangelos Paraskevaidis, Dimitris Mavridis

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The plethora of diagnostic test accuracy (DTA) studies has led to the increased use of systematic reviews and meta-analysis of DTA studies. Clinicians and healthcare professionals often consult DTA meta-analyses to make informed decisions regarding the optimum test to choose and use for a given setting. For example, the human papilloma virus (HPV) DNA, mRNA, and cytology can be used for the cervical intraepithelial neoplasia grade 2+ (CIN2+) diagnosis. But which test is the most accurate? Studies directly comparing test accuracy are not always available, and comparisons between multiple tests create a network of DTA studies that can be synthesized through a network meta-analysis of diagnostic tests (DTA-NMA). The aim is to summarize the DTA-NMA methods for at least three index tests presented in the methodological literature. We illustrate the application of the methods using a real data set for the comparative accuracy of HPV DNA, HPV mRNA, and cytology tests for cervical cancer. A search was conducted in PubMed, Web of Science, and Scopus from inception until the end of July 2019 to identify full-text research articles that describe a DTA-NMA method for three or more index tests. Since the joint classification of the results from one index against the results of another index test amongst those with the target condition and amongst those without the target condition are rarely reported in DTA studies, only methods requiring the 2x2 tables of the results of each index test against the reference standard were included. Studies of any design published in English were eligible for inclusion. Relevant unpublished material was also included. Ten relevant studies were finally included to evaluate their methodology. DTA-NMA methods that have been presented in the literature together with their advantages and disadvantages are described. In addition, using 37 studies for cervical cancer obtained from a published Cochrane review as a case study, an application of the identified DTA-NMA methods to determine the most promising test (in terms of sensitivity and specificity) for use as the best screening test to detect CIN2+ is presented. As a conclusion, different approaches for the comparative DTA meta-analysis of multiple tests may conclude to different results and hence may influence decision-making. Acknowledgment: This research is co-financed by Greece and the European Union (European Social Fund- ESF) through the Operational Programme «Human Resources Development, Education and Lifelong Learning 2014-2020» in the context of the project “Extension of Network Meta-Analysis for the Comparison of Diagnostic Tests ” (MIS 5047640).

Keywords: colposcopy, diagnostic test, HPV, network meta-analysis

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Authors: Sven Borén, Lisiana Nurhadi, Henrik Ny

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From a theoretical perspective, electric buses can be more sustainable and can be cheaper than fossil fuelled buses in city traffic. The authors have not found other studies based on actual urban public transport in Swedish winter climate. Further on, noise measurements from buses for the European market were found old. The aims of this follow-up study was therefore to test and possibly verify in a real-life environment how energy efficient and silent electric buses are, and then conclude on if electric buses are preferable to use in public transport. The Ebusco 2.0 electric bus, fitted with a 311 kWh battery pack, was used and the tests were carried out during November 2014-April 2015 in eight municipalities in the south of Sweden. Six tests took place in urban traffic and two took place in more of a rural traffic setting. The energy use for propulsion was measured via logging of the internal system in the bus and via an external charging meter. The average energy use turned out to be 8% less (0,96 kWh/km) than assumed in the earlier theoretical study. This rate allows for a 320 km range in public urban traffic. The interior of the bus was kept warm by a diesel heater (biodiesel will probably be used in a future operational traffic situation), which used 0,67 kWh/km in January. This verified that electric buses can be up to 25% cheaper when used in public transport in cities for about eight years. The noise was found to be lower, primarily during acceleration, than for buses with combustion engines in urban bus traffic. According to our surveys, most passengers and drivers appreciated the silent and comfortable ride and preferred electric buses rather than combustion engine buses. Bus operators and passenger transport executives were also positive to start using electric buses for public transport. The operators did however point out that procurement processes need to account for eventual risks regarding this new technology, along with personnel education. The study revealed that it is possible to establish a charging infrastructure for almost all studied bus lines. However, design of a charging infrastructure for each municipality requires further investigations, including electric grid capacity analysis, smart location of charging points, and tailored schedules to allow fast charging. In conclusion, electric buses proved to be a preferable alternative for all stakeholders involved in public bus transport in the studied municipalities. However, in order to electric buses to be a prominent support for sustainable development, they need to be charged either by stand-alone units or via an expansion of the electric grid, and the electricity should be made from new renewable sources.

Keywords: sustainability, electric, bus, noise, greencharge

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Authors: Warner Woodworth

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While the explosion of autocratic governments is growing globally, perhaps nowhere is it more obvious than in the United States since 2015. In that nation, democracy is increasingly caving to extreme Right-wing movements, especially after Donald Trump lost to Joe Biden in the 2020 election. Angered by that rejection, he and his support groups that foster extremism began an all-out assault on freedom, beginning with the attack on the US Capitol itself on January 6, 2021. Since then, following Trump’s two presidential impeachments, 34 felony convictions, 88 impending court cases by the Department of Justice, and crimes by some of his most ardent co-conspirators, the rule of law, traditional political values, and even the Constitution became threatened. Now, since his Nov. 5, 2024, campaign victory, the dark clouds of autocracies loom larger every day. To wit: Appointments to Trump’s cabinet are all extremists promising to eliminate major beneficiary citizen programs such as healthcare, civil rights, education, justice, and a massive move to drive millions of immigrants from the country. The political divide is at its highest extreme since the 1861 Civil War between North and South. Autocratization is manifest daily in fake news media, as well as traditional conspiracy organizations such as politically violent motorcycle gangs, the John Birch Society, Eagle Forum, and Anti-Constitutional Sheriffs and other law enforcement groups. Even worse is the expansion of violent groups such as the Proud Boys, Aryan Nations, Patriot Front, White Nationalists, Stormfront, Oath Keepers, Three Percenters, Ku Klux Klan, Moms for Liberty, American Nazi Party, Operation Homeland, Skinhead organizations, America First, Veterans on Patrol, hundreds of militia groups from coast to coast, and of course, hundreds more under the banner of Trump’s movement, ‘Make America Great Again.’ This paper will draw on the author’s decades of researching these groups and Trump's new authoritarian agenda. Qualitative data will include expert analysis from multiple academic disciplines as Americans, and the larger world seek to understand these dangerous U.S. trends and future prospects. The paper concludes by sharing the prospects of America’s future over the next four years, or longer if Trump’s vow to be a dictator is extended.

Keywords: American authoritarianism, trump, fascism, conspiracies, extremism

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Authors: Animish Jain

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This study deals with using Multiplicative Weight Update within artificial intelligence and machine learning to create models that can diagnose skin cancer using microscopic images of cancer samples. In this study, the multiplicative weight update method is used to take the predictions of multiple models to try and acquire more accurate results. Logistic Regression, Convolutional Neural Network (CNN), and Support Vector Machine Classifier (SVMC) models are employed within the Multiplicative Weight Update system. These models are trained on pictures of skin cancer from the ISIC-Archive, to look for patterns to label unseen scans as either benign or malignant. These models are utilized in a multiplicative weight update algorithm which takes into account the precision and accuracy of each model through each successive guess to apply weights to their guess. These guesses and weights are then analyzed together to try and obtain the correct predictions. The research hypothesis for this study stated that there would be a significant difference in the accuracy of the three models and the Multiplicative Weight Update system. The SVMC model had an accuracy of 77.88%. The CNN model had an accuracy of 85.30%. The Logistic Regression model had an accuracy of 79.09%. Using Multiplicative Weight Update, the algorithm received an accuracy of 72.27%. The final conclusion that was drawn was that there was a significant difference in the accuracy of the three models and the Multiplicative Weight Update system. The conclusion was made that using a CNN model would be the best option for this problem rather than a Multiplicative Weight Update system. This is due to the possibility that Multiplicative Weight Update is not effective in a binary setting where there are only two possible classifications. In a categorical setting with multiple classes and groupings, a Multiplicative Weight Update system might become more proficient as it takes into account the strengths of multiple different models to classify images into multiple categories rather than only two categories, as shown in this study. This experimentation and computer science project can help to create better algorithms and models for the future of artificial intelligence in the medical imaging field.

Keywords: artificial intelligence, machine learning, multiplicative weight update, skin cancer

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Authors: Dawid Sołoducha, Tomasz Borowski, Agata Markowska-Szczupak, Aneta Wesołowska, Marian Kordas, Rafał Rakoczy

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Many studies report varied effects of the magnetic field in medicine, but applications are still missing. Also, essential oils (EOs) were historically used in healing therapies, food preservation and the cosmetic industry due to their wound healing and antioxidant properties and antimicrobial activity. Unfortunately, the chemical characterization of EOs activates its antibacterial action only at a fairly high concentration. They can cause skin reactions, e.g., irritation (irritant contact dermatitis) or allergic contact dermatitis; therefore, they should always be used with caution. However, the administration of EOs to achieve the desired antimicrobial activity and stability with long-term medical usage in low concentration is challenging. The aim of this work was to investigate the antimicrobial activity of commercial Pinus sylvestris L. essential oil from Polish company Avicenna-Oil® under Rotating Magnetic Field (RMF) at f = 1 – 50 Hz. The novel construction of the magnetically assisted self-constructed reactor (MAP) was applied for this study. The chemical composition of essential pine oil was determined by gas chromatography coupled with mass spectrometry (GC-MS). Model bacteria Escherichia coli K12 (ATCC 25922) was used. Different concentrations of pine oil was prepared: 100% 50%, 25%, 12.5% and 6.25%. The disc diffusion and MIC test were done. To examine the effect of essential pine oil and rotating magnetic field RMF on antibacterial performance agar plate method was used. Pine oil consist of α-pinene (28.58%), β-pinene (17.79%), δ-3-carene (14.17%) and limonene (11.58%). The present study indicates the exposition to the RMF, as compared to the unexposed controls causing an increase in the efficacy of antibacterial properties of pine oil. We have shown that the rotating magnetic fields (RMF) at a frequency, f, between 25 Hz to 50 Hz, increase the antimicrobial efficiency of oil at lower than 50% concentration. The new method can be applied in many fields e.g. aromatherapy, medicine as a component of dressing, or as food preservatives.

Keywords: rotating magnetic field, pine oil, antimicrobial activity, Escherichia coli

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Authors: Charles Chijioke Dike, Hugh Clifford Chima Maduka, Chinwe A. Isibor

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Fish is among the products consumed at a very high rate. In most countries of the world, fish are used as part of the daily meal. The high cost of commercial fish feeds in Africa has made it necessary the development of an alternative source of fish feed processing from organic waste. The objective of this research is to investigate the efficacy of fish feeds processed from various animal wastes in order to know whether those feeds shall be alternatives to commercial feeds. This work shall be carried out at the Research Laboratory Unit of the Department of Human Biochemistry, Faculty of Basic Medical Sciences, College of Health Sciences, Nnamdi Azikiwe University (NAU), Nnewi Campus, Anambra State. The fingerlings to be used shall be gotten from the Agricultural Department of NAU, Awka, Anambra State, and allowed to acclimatize for 14 d. Animal and food wastes shall be gotten from Nnewi. The fish shall be grouped into 1-13 (Chicken manure only, cow dung only, pig manure only, chicken manure + yeast, cow dung + yeast, pig manure + yeast, chicken manure + other wastes + yeast, cow dung + other wastes + yeast, and pig manure + other wastes + yeast. Feed assessment shall be carried out by determining bulk density, feed water absorption, feed hardness, feed oil absorption, and feed water stability. The nutritional analysis shall be carried out on the feeds processed. The risk assessment shall be done on the fish by determining methylmercury (MeHg), polycyclic aromatic hydrocarbons (PAHs), and dichloro-diphenyl-trichloroethane (DDT) in the fish. The results from this study shall be analyzed statistically using SPSS statistical software, version 25. The hypothesis is that fish feeds processed from animal wastes are efficient in raising catfish. The outcome of this study shall provide the basis for the formulation of fish feeds from organic wastes.

Keywords: assessment, feeds, health risk, wastes

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Authors: Changaiz Khan

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Pakistan has the highest rates of maternal mortality in South Asia. From the year 2000 to 2017 the global rate of maternal mortality has decreased up to 39 %. In the context of South Asia, it has decreased by 59% since 2000s. Pakistan has also reduced the rate of maternal mortality, but there is a difference on the provincial level. According to the report of the National Institute of Population Studies (NIPS) conducted in 2020, the MMR in Balochistan has crossed the ratio of most of the South Asian countries, i.e., 298 maternal deaths per 100,000 live births. In comparison, the province of Punjab has the lowest maternal mortality rate i.e. 157 deaths (per 100,000 live births). The rate of maternal mortality is much higher in Balochistan as compared to the other provinces. This research is aimed to discuss the supply side barriers and utilization of maternal healthcare services in the District Gwadar. Likert scale survey method has been used to collect data from the Healthcare Professionals from hospitals -private and government- and the maternal healthcare receiver, that is patient. Semi-structured interviews of healthcare professionals such as doctors, nurses, and Lab technicians have also been conducted. It has been found in this research study that the hospitals in Gwadar district are lagging behind in providing modern maternal healthcare to women due to the lack of staff training, medicine supply, and Laboratories. Moreover, the system of the lady health worker is also not catering to the needs of the women in District Gwadar. It has been recommended in the study that first of all the government should fulfill the supply of the medicine in the hospital. Secondly, the government should open laboratories in the hospitals. Thirdly, the government should increase the funding of the government hospital and the allocation of lady health workers in District Gwadar, Balochistan should be increased.

Keywords: maternal mortality, neonatal, postnatal, supply barriers, patients, healthcare professionals, laboratory, medical supply, training

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Authors: Akram Boubakri, Fethi Choubani, Tan Hoa Vuong, Jacques David

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Nowadays, microwave hyperthermia is considered as an effective treatment for the malignant tumors. This microwave treatment which comes to substitute the chemotherapy and the surgical intervention enables an in-depth tumor heating without causing any diseases to the sane tissue. This technique requires a high precision system, in order to effectively concentrate the heating just in the tumor, without heating any surrounding healthy tissue. In the hyperthermia treatment, the temperature in cancerous area is typically raised up to over 42◦C and maintained for one hour in order to destroy the tumor sufficiently, whilst in the surrounding healthy tissues, the temperature is maintained below 42◦C to avoid any damage. Metamaterial lenses are widely used in medical applications like microwave hyperthermia treatment. They enabled a subdiffraction resolution thanks to the amplification of the evanescent waves and they can focus electromagnetic waves from a point source to a point image. Metasurfaces have been used to built metamaterial lenses. The main mechanical advantages of those structures over three dimensional material structures are ease of fabrication and a smaller required volume. Here in this work, we proposed a metasurface based lens operating at the frequency of 6 GHz and designed for microwave hyperthermia. This lens was applied and showed good results in focusing and heating the tumor inside a breast tissue with an increased and maintained temperature above 42°C. The tumor was placed in the focal distance of the lens so that only the tumor tissue will be heated. Finally, in this work, it has been shown that the hyperthermia area within the tissue can be carefully adjusted by moving the antennas or by changing the thickness of the metamaterial lenses based on the tumor position. Even though the simulations performed in this work have taken into account an ideal case, some real characteristics can be considered to improve the obtained results in a realistic model.

Keywords: focusing, hyperthermia, metamaterial lenses, metasurface, microwave treatment

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Authors: Freya Willicks

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The society of the 21st century is characterized by dynamic and complexity, developments that also shape universities and university life. The Bologna reform, for example, has led to restructuring at many European universities. Today's university teachers, therefore, have to meet many expectations: Their tasks include not only teaching but also the general improvement of the quality of teaching, good research, the management of various projects or the development of their own personal skills. This requires a high degree of flexibility and openness to change. The resulting pressure can often lead to exhaustion. Coaching can be a way for university teachers to cope with these pressures because it gives them the opportunity to discuss stressful situations with a coach and self-reflect on them. As a result, more and more universities in Europe offer to coach to their teachers. An analysis of the services provided at universities in Germany, however, quickly reveals an immense disagreement with regard to the understanding of ‘coaching’. A variety of terms is used, such as coaching, counselling or supervision. In addition, each university defines its offer individually, from process-oriented consulting to expert consulting, from group training to individual coaching. The biographic backgrounds of those who coach are also very divergent, both external and internal coaches can be suitable. These findings lead to the following questions: Which structural characteristics for coaching at universities have been proven successful? What competencies should a good coach for university lecturers have? In order to answer these questions, a qualitative study was carried out. In a first step, qualitative semi-structured interviews (N = 14) were conducted, on the one hand with coaches for university teachers and on the other hand with university teachers who have been coached. In a second step, the interviews were transcribed and analyzed using Mayring's qualitative content analysis. The study shows how great the potential of coaching can be for university teachers, who otherwise have little opportunity to talk about their teaching in a private setting. According to the study, the coach should neither be a colleague nor a superior of the coachee but should take an independent perspective, as this is the only way for the coachee to openly reflect on himself/herself. In addition, the coach should be familiar with the university system, i.e., be an academic himself/herself. Otherwise, he/she cannot fully understand the complexity of the teaching situation and the role expectations. However, internal coaches do not necessarily have much coaching experience or explicit coaching competencies. They often come from the university's own didactics department, are experts in didactics, but do not necessarily have a certified coaching education. Therefore, it is important to develop structures and guidelines for internal coaches to support their coaching. In further analysis, such guidelines will be developed on the basis of these interviews.

Keywords: coaching, university coaching, university didactics, qualitative interviews

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Authors: Bo-Jian Wu, Si-Heng Wu

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Objectives: Frailty is a condition of a person who has chronic health problems complicated by a loss of physiological reserve and deteriorating functional abilities. The frailty syndrome was defined by Fried and colleagues, i.e., weight loss, fatigue, decreased grip strength, slow gait speed, and low physical activity. However, to our best knowledge, there have been rare studies exploring the prevalence of frailty and its association with falls in patients with schizophrenia. Methods: A total of 559 hospitalized patients were recruited from a public psychiatric hospital in 2013. The majority of the subjects were males (361, 64.6%). The average age was 53.5 years. All patients received the assessment of frailty status defined by Fried and colleagues. The status of a fall within one year after the assessment of frailty, clinical and demographic data was collected from medical records. Logistic regression was used to calculate the odds ratio of associated factors. Results : A total of 9.2% of the participants met the criteria of frailty. The percentage of patients having a fall was 7.2%. Age were significantly associated with frailty (odds ratio = 1.057, 95% confidence interval = 1.025-1.091); however, sex was not associated with frailty (p = 0.17). After adjustment for age and sex, frailty status was associated with a fall (odds ratio = 3.62, 95% confidence interval = 1.58-8.28). Concerning the components of frailty, decreased grip strength (odds ratio = 2.44, 95% confidence interval = 1.16-5.14), slow gait speed (odds ratio = 2.82, 95% confidence interval = 1.21-6.53), and low physical activity (odds ratio = 2.64, 95% confidence interval = 1.21-5.78) were found to be associated with a fall. Conclusions: Our findings suggest the prevalence of frailty was about 10% in hospitalized patients with chronic patients with schizophrenia, and frailty status was significant with a fall in this group. By using the status of frailty, it may be beneficial to potential target candidates having fallen in the future as early as possible. The effective intervention of prevention of further falls may be given in advance. Our results bridge this gap and open a potential avenue for the prevention of falls in patients with schizophrenia. Frailty is certainly an important factor for maintaining wellbeing among these patients.

Keywords: fall, frailty, schizophrenia, Taiwan

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Authors: Jasmina Pluncevic Gligoroska, Sanja Manchevska, Vaska Antevska, Lidija Todorovska, Beti Dejanova, Sunchica Petrovska, Ivanka Karagjozova, Elizabeta Sivevska

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Introduction: Anthropometric measurements are integral part of regular medical examinations of athletes. In addition to the quantification of the size of the body, these measurements indicate the quality of the physical status, because of its association with sports performance. The purpose of this study was to examine whether there are differences in anthropometric parameters and body mass components in female athletes who participate in two different types of sports. Methods: A total of 27 athletes, 15 handball players and 12 basketball players, at the average age of 22.7 years (age span from 17 to 30 years) entered the study. Anthropometric method by Matiegka was used for determination of body components. Sixteen anthropometric measures were taken: height, weight, four diameters of joints, four circumferences of limbs and six skin folds. Results: Handball players were 169.6±6.7 cm tall and 63,75±7.5 kg heavy. Their average relative muscle mass (absolute mass in kg) was 51% (32.5kg), while bone component was 16.8% (10.7kg) and fat component was 14.3% (7.74kg). The basketball players were 177.4±8.2cm tall and 70.37±12.1kg heavy. Their average relative muscle mass (absolute mass in kg) was 51.9 % (36.6kg), bone component was 16.37% (11.5kg) and fat component was 15.36% (9.4kg). The comparison of anthropometric values showed that basketball players were statistically significantly higher and heavier than handball players (p<0.05). Statistically significant difference (p<0.05) was observed in the range of upper leg circumference (higher in basketball players) and the forearm skin fold (higher in the basketball players). Conclusion: Handball players and basketball players significantly differed in basic anthropometric measures (height and weight), but the body components had almost identical values. The anthropometric measurements that have been taken did not show significant difference between handball and basketball female players despite the different physical demands of the games.

Keywords: anthropometry, body components, basketball, handball female players

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Authors: Rebecca-Lee Kuhnert, Ron Rapee

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Up to 15% of Australian youth will experience an emotional disorder, yet relatively few get the help they need. Schools provide an ideal environment through which we can identify young people who are struggling and provide them with appropriate help. Universal mental health screening is a method by which all young people in school can be quickly assessed for emotional disorders, after which identified youth can be linked to appropriate health services. Despite the obvious logic of this process, universal mental health screening has received little scientific evaluation and even less application in Australian schools. This study will develop methods for Australian education systems to help identify young people (aged 9-17 years old) who are struggling with existing and emerging emotional disorders. Prior to testing, a series of focus groups will be run to get feedback and input from young people, parents, teachers, and mental health professionals. They will be asked about their thoughts on school-based screening methods and and how to best help students at risk of emotional distress. Schools (n=91) across New South Wales, Australia will be randomised to do either immediate screening (in May 2021) or delayed screening (in February 2022). Students in immediate screening schools will complete a long online mental health screener consisting of standard emotional health questionnaires. Ultimately, this large set of items will be reduced to a small number of items to form the final brief screener. Students who score in the “at-risk” range on any measure of emotional health problems will be identified to schools and offered pathways to relevant help according to the most accepted and approved processes identified by the focus groups. Nine months later, the same process will occur among delayed screening schools. At this same time, students in the immediate screening schools will complete screening for a second time. This will allow a direct comparison of the emotional health and help-seeking between youth whose schools had engaged in the screening and pathways to care process (immediate) and those whose schools had not engaged in the process (delayed). It is hypothesised that there will be a significant increase in students who receive help from mental health support services after screening, compared with baseline. It is also predicted that all students will show significantly less emotional distress after screening and access to pathways of care. This study will be an important contribution to Australian youth mental health prevention and early intervention by determining whether school screening leads to a greater number of young people with emotional disorders getting the help that they need and improving their mental health outcomes.

Keywords: children and young people, early intervention, mental health, mental health screening, prevention, school-based mental health

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Authors: Rita Lopa, Yukihiro Shimatani

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The focus of this research is 880m extension development along the Kamisaigo River. The river is flowing tributary of grade 2 rivers Fukutsu City, Fukuoka Prefecture. This river is a small-scale urban river and the river was formerly a straight concrete sea wall construction. The river runs through National Highway No. 3 from the confluence of Saigo River. The study covers the river basin about 326 ha with a catchment area of 20.63 ha and 4,700 m3 capacity regulating pond. The river is not wide, shallow, and has a straight alignment with active (un-vegetated) river channel sinuosity (ratio of river length to valley length) ranging between 1 and 1.3. However, the alignment of the low-flow river channel does have meandering or sinuous characteristics. Flooding is likely to occur. It has become difficult to live in the environment for organisms of the river. Hydrophilic is very low (children cannot play). There is little connection with the local community. Overall, the Kamisaigo River watershed is heavily urbanized and from a morphological, biological and habitat perspective, Kamisaigo River functions marginally not well. For river improvement and maintenance of the Kamisaigo River, the workshop was conducted in the form of planning for the proposed model is presented by the Watershed Management Laboratory. This workshop showed the relationship between citizens, City Government, and University of mutual trust has been established, that have been made landscape, environment, usage, etc.: retaining wall maintenance, hydrophilic zone, landscape zone, nature walks zone: adjacent medical facilities and adjacent to large commercial facilities. Propose of Nature walks zone with point of the design: provide slope that the wheelchair can access and walking paths to enjoy the scenery, and summary of the Kamisaigo River workshop: creating a multi-model study and creation of natural rivers.

Keywords: river restoration, river improvement, natural rivers, Saigo River

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Authors: Petronella Lunda, Catharina Susanna Minnie, Welma Lubbe

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Background This review aimed to provide healthcare professionals with a scientific summary of the best available research evidence on factors influencing respectful perinatal care. The review question was ‘What were the perceptions of midwives and doctors on factors that influence respectful perinatal care?’ Methods A detailed search was done on electronic databases: EBSCOhost: Medline, OAlster, Scopus, SciELO, Science Direct, PubMed, Psych INFO, and SocINDEX. The databases were searched for available literature using a predetermined search strategy. Reference lists of included studies were analysed to identify studies missing from databases. The phenomenon of interest was factors influencing maternity care practices according to midwives and doctors. Pre-determined inclusion and exclusion criteria were used during the selection of potential studies. In total, 13 studies were included in the data analysis and synthesis. Three themes were identified and a total of nine sub-themes. Results Studies conducted in various settings were included in the study. Multiple factors influencing respectful perinatal care were identified. During data synthesis, three themes emerged: healthcare institution, healthcare professionals, and women-related factors. Alongside the themes were sub-themes human resources, medical supplies, norms and practices, physical infrastructure, healthcare professional competencies and attributes, women’s knowledge, and preferences. The three factors influence the provision of respectful perinatal care; addressing them might improve the provision of the care. Conclusion Addressing factors that influence respectful perinatal care is vital towards the prevention of compromised patient care during the perinatal period as these factors have the potential to accelerate or hinder provision of respectful care.

Keywords: doctors, maternity care, midwives, obstetrician, perceptions, perinatal care, respectful care

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Authors: Arman Kishan, Mark Haft, Steve Li, Duc Nguyen, Dawn Laporte

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Objective: Patients with Type 2 diabetes (T2DM) often face higher postoperative complication rates. Limited data exist on outcomes in T2DM patients undergoing carpal tunnel release (CTR). This study aims to compare complication rates between endoscopic CTR (ECTR) and open CTR (OCTR) in patients with T2DM. Methods: This was a retrospective cohort study using the TriNetX database of 56741 patients with T2DM undergoing ECTR (N= 14,949) or OCTR (N= 41,792). Demographic data, medical comorbidities, and complication rates were analyzed. We used multivariable analysis to identify differences in postoperative complication rates between the two treatment methods in patients with T2DM. Results: Patients with T2DM undergoing ECTR had a significantly lower incidence of 90-day wound infection (p < 0.001), 90-day wound dehiscence (p < 0.001), and nerve injury (p < 0.001) when compared to patients who underwent OCTR. After matching, there was a significantly higher number of T2DM patients undergoing ECTR who had peripheral vascular disease (p = 0.045) and hypertension (p = 0.020) when compared to the OCTR group. These patients also had a lower incidence of fluid and electrolyte disorders (p = 0.002) and chronic blood loss anemia (p = 0.025). Conclusion: ECTR presents a superior choice for T2DM patients undergoing CTR, yielding significantly lower rates of wound infection, wound dehiscence, and nerve injury within 90 days post-surgery—reducing the risk by 31%, 48%, and 59%, respectively. These findings support the adoption of ECTR as the preferred method in this patient population, potentially leading to improved postoperative outcomes.

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, carpal tunnel syndrome, postoperative complications in patients with diabetes mellitus

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Authors: Michael Adebayo, Saheed Lawal

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The Comprehensive Geriatric Assessment (CGA) is the multidimensional tool used to assess elderly, frail patients either on admission to hospital care or at a community level in primary care. It is a tool designed with the aim of using a holistic approach to managing patients. A Cochrane review of CGA use in 2011 found that the likelihood of being alive and living in their own home rises by 30% post-discharge. RCTs have also discovered 10–15% reductions in readmission rates and reductions in institutionalization, and resource use and costs. Past audit cycles at King’s College Hospital, Denmark Hill had shown inconsistent evidence of CGA completion inpatient discharge summaries (less than 50%). Junior Doctors in the Health and Ageing (HAU) wards have struggled to sustain the efforts of past audit cycles due to the quick turnover in staff (four-month placements for trainees). This 7th cycle created a multi-faceted approach to solving this problem amongst staff and creating lasting change. Methods: 1. We adopted multidisciplinary team involvement to support Doctors. MDT staff e.g. Nurses, Physiotherapists, Occupational Therapists and Dieticians, were actively encouraged to fill in the CGA document. 2. We added a CGA Document Pro-forma to “Sunrise EPR” (Trust computer system). These CGAs were to automatically be included the discharge summary. 3. Prior to assessing uptake, we used a spot audit questionnaire to assess staff awareness/knowledge of what a CGA was. 4. We designed and placed posters highlighting domains of CGA and MDT roles suited to each domain on geriatric “Health and Ageing Wards” (HAU) in the hospital. 5. We performed an audit of % discharge summaries which include CGA and MDT role input. 6. We nominated ward champions on each ward from each multidisciplinary specialty to monitor and encourage colleagues to actively complete CGAs. 7. We initiated further education of ward staff on CGA's importance by discussion at board rounds and weekly multidisciplinary meetings. Outcomes: 1. The majority of respondents to our spot audit were aware of what a CGA was, but fewer had used the EPR document to complete one. 2. We found that CGAs were not being commenced for nearly 50% of patients discharged on HAU wards and the Frailty Assessment Unit.

Keywords: comprehensive geriatric assessment, CGA, multidisciplinary team, quality of life, mortality

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Authors: Chongyang Ye, Rong Liu

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Elastic compression stockings (ECSs) have been widely applied in prophylaxis and treatment of chronic venous insufficiency of lower extremities. The medical function of ECS is to improve venous return and increase muscular pumping action to facilitate blood circulation, which is largely determined by the complex interaction between the ECS and lower limb tissues. Understanding the mechanical transmission of ECS along the skin surface, deeper tissues, and vascular system is essential to assess the effectiveness of the ECSs. In this study, a three-dimensional (3D) finite element (FE) model of the leg-ECS system integrated with a 3D fluid-solid interaction (FSI) model of the leg-vein system was constructed to analyze the biomechanical properties of veins and soft tissues under different ECS compression. The Magnetic Resonance Imaging (MRI) of the human leg was divided into three regions, including soft tissues, bones (tibia and fibula) and veins (peroneal vein, great saphenous vein, and small saphenous vein). The ECSs with pressure ranges from 15 to 26 mmHg (Classes I and II) were adopted in the developed FE-FSI model. The soft tissue was assumed as a Neo-Hookean hyperelastic model with the fixed bones, and the ECSs were regarded as an orthotropic elastic shell. The interfacial pressure and stress transmission were simulated by the FE model, and venous hemodynamics properties were simulated by the FSI model. The experimental validation indicated that the simulated interfacial pressure distributions were in accordance with the pressure measurement results. The developed model can be used to predict interfacial pressure, stress transmission, and venous hemodynamics exerted by ECSs and optimize the structure and materials properties of ECSs design, thus improving the efficiency of compression therapy.

Keywords: elastic compression stockings, fluid-solid interaction, tissue and vein properties, prediction

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Authors: Dong Zhan

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China sports science is the core periodical of scientific research in the field of sports in China at present. It is the first academic periodical ranked in China. The author has studied the characteristics and trends of articles on sports medicine and physical fitness published in the journal since it founded. Now, the articles on sports medicine and physical fitness published in the Journal of Sports Science from 2013 to 2017 are reviewed. The results show that 1) The characteristics of previous sports medicine articles showed that there were more articles on the basis of sports medicine than that on the application. The research on animal experiments was far more than that on the human body. Moreover, the trend was getting worse and worse as time goes on. But in the past five years, there had been a marked improvement. The basic/application has been improved from 2.1/1 to 1.3/1. This shows that sports medicine researchers have been paid more attention to the application research in sports medicine. 2) There are few articles on sports injury, because the state put the sports injury specialty into the medical colleges, and the research scope of sports research institutes does not include sports injury. It cannot meet the need for the development of sports medicine, and it should change sooner or later. 3) In the past, researchers’ effort was on athletes' physical health, not on ordinary people. Now, there is a great change, they not only research on the sportsmen’s health but also research on the health of the ordinary people. 4) Researchers mainly studied on the young people’s physical fitness in the past; now, it has been greatly improved. Researchers study on the physical health of the elderly, especially those over the age of 60. Numbers of paper researching on the young were much more than those on the old. In the past 10 years, the ratio of number of paper researching on the young to the old people was (young/old) 16.6/1, while in the past 5 years, this ratio was 6.3/1. However, this is not enough. China has a large population and needs to focus on promoting the health of the people. Conclusion: It is important to pay more attention to the application research on sports medicine and on the physical fitness, and it is also important to make a research on physical health of the elderly.

Keywords: sports medicine, people's health, the young, the old

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