Search results for: basic life support
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 15408

Search results for: basic life support

4068 Radial Basis Surrogate Model Integrated to Evolutionary Algorithm for Solving Computation Intensive Black-Box Problems

Authors: Abdulbaset Saad, Adel Younis, Zuomin Dong

Abstract:

For design optimization with high-dimensional expensive problems, an effective and efficient optimization methodology is desired. This work proposes a series of modification to the Differential Evolution (DE) algorithm for solving computation Intensive Black-Box Problems. The proposed methodology is called Radial Basis Meta-Model Algorithm Assisted Differential Evolutionary (RBF-DE), which is a global optimization algorithm based on the meta-modeling techniques. A meta-modeling assisted DE is proposed to solve computationally expensive optimization problems. The Radial Basis Function (RBF) model is used as a surrogate model to approximate the expensive objective function, while DE employs a mechanism to dynamically select the best performing combination of parameters such as differential rate, cross over probability, and population size. The proposed algorithm is tested on benchmark functions and real life practical applications and problems. The test results demonstrate that the proposed algorithm is promising and performs well compared to other optimization algorithms. The proposed algorithm is capable of converging to acceptable and good solutions in terms of accuracy, number of evaluations, and time needed to converge.

Keywords: differential evolution, engineering design, expensive computations, meta-modeling, radial basis function, optimization

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4067 Analysis of the Occurrence of Hydraulic Fracture Phenomena in Roudbar Lorestan Dam

Authors: Masoud Ghaemi, MohammadJafar Hedayati, Faezeh Yousefzadeh, Hoseinali Heydarzadeh

Abstract:

According to the statistics of the International Committee on Large Dams, internal erosion and piping (scour) are major causes of the destruction of earth-fill dams. If such dams are constructed in narrow valleys, the valley walls will increase the arching of the dam body due to the transfer of vertical and horizontal stresses, so the occurrence of hydraulic fracturing in these embankments is more likely. Roudbar Dam in Lorestan is a clay-core pebble earth-fill dam constructed in a relatively narrow valley in western Iran. Three years after the onset of impoundment, there has been a fall in dam behavior. Evaluation of the dam behavior based on the data recorded on the instruments installed inside the dam body and foundation confirms the occurrence of internal erosion in the lower and adjacent parts of the core on the left support (abutment). The phenomenon of hydraulic fracturing is one of the main causes of the onset of internal erosion in this dam. Accordingly, the main objective of this paper is to evaluate the validity of this hypothesis. To evaluate the validity of this hypothesis, the dam behavior during construction and impoundment has been first simulated with a three-dimensional numerical model. Then, using validated empirical equations, the safety factor of the occurrence of hydraulic fracturing phenomenon upstream of the dam score was calculated. Then, using the artificial neural network, the failure time of the given section was predicted based on the maximum stress trend created. The study results show that steep slopes of valley walls, sudden changes in coefficient, and differences in compressibility properties of dam body materials have caused considerable stress transfer from core to adjacent valley walls, especially at its lower levels. This has resulted in the coefficient of confidence of the occurrence of hydraulic fracturing in each of these areas being close to one in each of the empirical equations used.

Keywords: arching, artificial neural network, FLAC3D, hydraulic fracturing, internal erosion, pore water pressure

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4066 Field Trial of Resin-Based Composite Materials for the Treatment of Surface Collapses Associated with Former Shallow Coal Mining

Authors: Philip T. Broughton, Mark P. Bettney, Isla L. Smail

Abstract:

Effective treatment of ground instability is essential when managing the impacts associated with historic mining. A field trial was undertaken by the Coal Authority to investigate the geotechnical performance and potential use of composite materials comprising resin and fill or stone to safely treat surface collapses, such as crown-holes, associated with shallow mining. Test pits were loosely filled with various granular fill materials. The fill material was injected with commercially available silicate and polyurethane resin foam products. In situ and laboratory testing was undertaken to assess the geotechnical properties of the resultant composite materials. The test pits were subsequently excavated to assess resin permeation. Drilling and resin injection was easiest through clean limestone fill materials. Recycled building waste fill material proved difficult to inject with resin; this material is thus considered unsuitable for use in resin composites. Incomplete resin permeation in several of the test pits created irregular ‘blocks’ of composite. Injected resin foams significantly improve the stiffness and resistance (strength) of the un-compacted fill material. The stiffness of the treated fill material appears to be a function of the stone particle size, its associated compaction characteristics (under loose tipping) and the proportion of resin foam matrix. The type of fill material is more critical than the type of resin to the geotechnical properties of the composite materials. Resin composites can effectively support typical design imposed loads. Compared to other traditional treatment options, such as cement grouting, the use of resin composites is potentially less disruptive, particularly for sites with limited access, and thus likely to achieve significant reinstatement cost savings. The use of resin composites is considered a suitable option for the future treatment of shallow mining collapses.

Keywords: composite material, ground improvement, mining legacy, resin

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4065 System Dynamics Projections of Environmental Issues for Domestic Water and Wastewater Scenarios in Urban Area of India

Authors: Isha Sharawat, R. P. Dahiya, T. R. Sreekrishnan

Abstract:

One of the environmental challenges in India is urban wastewater management as regulations and infrastructural development has not kept pace with the urbanization and growing population. The quality of life of people is also improving with the rapid growth of the gross domestic product. This has contributed to the enhancement in the per capita water requirement and consumption. More domestic water consumption generates more wastewater. The scarcity of potable water is making the situation quite serious, and water supply has to be regulated in most parts of the country during summer. This requires elaborate and concerted efforts to efficiently manage the water resources and supply systems. In this article, a system dynamics modelling approach is used for estimating the water demand and wastewater generation in a district headquarter city of North India. Projections are made till the year 2035. System dynamics is a software tool used for formulation of policies. On the basis of the estimates, policy scenarios are developed for sustainable development of water resources in conformity with the growing population. Mitigation option curtailing the water demand and wastewater generation include population stabilization, water reuse and recycle and water pricing. The model is validated quantitatively, and sensitivity analysis tests are carried out to examine the robustness of the model.

Keywords: system dynamics, wastewater, water pricing, water recycle

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4064 The Ugliness of Eating: Resistance to Depicting Consumption in Visual Arts

Authors: Constance Kirker

Abstract:

While there is general agreement that food itself can be beautiful, thousands of still-life masterpieces over the years attest to this, depicting the act of eating, actually placing food in one’s mouth and chewing is seemingly taboo. The environment created around consumption -dining rooms, linens, china, flowers- is consciously choreographed to provide a pleasing aesthetic experience. Yet artists, from Roman frescoes painters to contemporary photographers, create images from feasts to solitary subjects that rarely show food or drink touching lips, chewing, or swallowing. Of the countless paintings of the Last Supper, the food remains on the table. Rarely is Adam or Eve shown taking a bite of the apple, initiating Original Sin. In the few examples that do depict food-in-mouth, Goya’s Saturn Devouring His Son, or the ubiquitous photos of the “wedding smash” with brides and grooms pushing wedding cake into each other’s mouths, the images are seemingly intended to be particularly ugly or humorous in a distasteful way. This paper will explore theories that include the rules of etiquette, some determined hundreds of years ago and still followed today, that imply eating is a metaphor for gluttony, implicit sexuality of eating, the distortion of the face while eating and the simple practicality of the difficulty of an artist’s model maintaining a chewing position. If art is a reflection of society, what drives the universal impulse to hide this very human function?

Keywords: aesthetics, senses, taboo, consumption

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4063 Cilubaba: An Agriculture-Based Education Tool through Congklak Traditional Game as an Introduction of Home Garden for Children in Cibanteng, Bogor

Authors: Yoni Elviandri, Vivi Fitriyanti, Agung Surya Wijaya, Suryani Humayyah, Muhammad Alif Azizi

Abstract:

The massive development of computing power and internet access nowadays is marked by audiovisual games and computers which are known as electronic games, one of the examples is online games. This kind of game can be found everywhere in Indonesia, both in the cities and even the villages. In the present time, online games are becoming a popular games in various layers of the community, one of them does happen to elementary school students. As the online games spread over, the traditional games gradually fade away and even thought as an old-fashioned game. Contrary, traditional games actually have the better and higher educational values such as patience, honesty, integrity and togetherness value which cannot be found in online games which are more to individualist. A brand new set of education tools is necessary to provide a convenience, safe and fun place for children to play around but still contains educational values. One interesting example goes to Cilulaba is an agricultural-based playground. It is a good place for children to play and learn as it was planned to entertain children to play around as well as introducing agriculture to them. One of the games is a 1990’s well-known traditional game which its name is Congklak. Congklak is an agricultural-based traditional game and it also introduces the home garden to the children. Some of the Cilulaba’s aims are to protect the existence of nation’s cultural inheritance through Congklak traditional game, as a tool to introduce the agriculture to the children through the methods of Congklak traditional game and giving explanation related to the advantages of a “healthy home garden” to the children. The expected output from this place is to deliver a good understanding about agriculture to the children and make them begin to love it to make an aesthetic home garden and enhance the optimalisation usage of home garden that will support the availability of various edible plants in productive and health households. The proposed method in this Student Creative Program in Society Service is Participatory Rural Appraisal (PRA) method.

Keywords: Cilubaba, Congklak, traditional game, agricultural-based playground

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4062 Epigenetics Regulation Play Role in the Pathogenesis of Adipose Tissue Disorder, Lipedema

Authors: Musarat Ishaq, Tara Karnezis, Ramin Shayan

Abstract:

Lipedema, a poorly understood chronic disease of adipose hyper-deposition, is often mistaken for obesity and causes significant impairment to mobility and quality-of-life. To identify molecular mechanisms underpinning lipedema, we employed comprehensive omics-based comparative analyses of whole tissue, adipocyte precursors (adipose-derived stem cells (ADSCs)), and adipocytes from patients with or without lipedema. Transcriptional profiling revealed significant differences in lipedema tissue, adipocytes, and ADSCs, with altered levels of mRNAs involved inproliferation and cell adhesion. One highly up-regulated gene in lipedema adipose tissue, adipocytes and ADSCs, ZIC4, encodes Zinc Finger Protein ZIC 4, a class of transcription factor which may be involved in regulating metabolism and adipogenesis. ZIC4 inhibition impaired the adipogenesis of ADSCs into mature adipocytes. Epigenetic regulation study revealed overexpression of ZIC4 is involved in decreased promoter DNA methylation and subsequent decrease in adipogenesis. These epigenetic modifications can alter adipocytes microenvironment and adipocytes differentiation. Our study show that epigenetic events regulate the ability of ADSCs to commit and differentiate into mature adipocytes by modulating ZIC4.

Keywords: lipedema, adipose-derived stem cells, adipose tisue, adipocytes, zinc finger protein, epigenetic

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4061 Applications of Hyperspectral Remote Sensing: A Commercial Perspective

Authors: Tuba Zahra, Aakash Parekh

Abstract:

Hyperspectral remote sensing refers to imaging of objects or materials in narrow conspicuous spectral bands. Hyperspectral images (HSI) enable the extraction of spectral signatures for objects or materials observed. These images contain information about the reflectance of each pixel across the electromagnetic spectrum. It enables the acquisition of data simultaneously in hundreds of spectral bands with narrow bandwidths and can provide detailed contiguous spectral curves that traditional multispectral sensors cannot offer. The contiguous, narrow bandwidth of hyperspectral data facilitates the detailed surveying of Earth's surface features. This would otherwise not be possible with the relatively coarse bandwidths acquired by other types of imaging sensors. Hyperspectral imaging provides significantly higher spectral and spatial resolution. There are several use cases that represent the commercial applications of hyperspectral remote sensing. Each use case represents just one of the ways that hyperspectral satellite imagery can support operational efficiency in the respective vertical. There are some use cases that are specific to VNIR bands, while others are specific to SWIR bands. This paper discusses the different commercially viable use cases that are significant for HSI application areas, such as agriculture, mining, oil and gas, defense, environment, and climate, to name a few. Theoretically, there is n number of use cases for each of the application areas, but an attempt has been made to streamline the use cases depending upon economic feasibility and commercial viability and present a review of literature from this perspective. Some of the specific use cases with respect to agriculture are crop species (sub variety) detection, soil health mapping, pre-symptomatic crop disease detection, invasive species detection, crop condition optimization, yield estimation, and supply chain monitoring at scale. Similarly, each of the industry verticals has a specific commercially viable use case that is discussed in the paper in detail.

Keywords: agriculture, mining, oil and gas, defense, environment and climate, hyperspectral, VNIR, SWIR

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4060 A Causal Model for Environmental Design of Residential Community for Elderly Well-Being in Thailand

Authors: Porntip Ruengtam

Abstract:

This article is an extension of previous research presenting the relevant factors related to environmental perceptions, residential community, and the design of a healing environment, which have effects on the well-being and requirements of Thai elderly. Research methodology began with observations and interviews in three case studies in terms of the management processes and environment design of similar existing projects in Thailand. The interview results were taken to summarize with related theories and literature. A questionnaire survey was designed for data collection to confirm the factors of requirements in a residential community intended for the Thai elderly. A structural equation model (SEM) was formulated to explain the cause-effect factors for the requirements of a residential community for Thai elderly. The research revealed that the requirements of a residential community for Thai elderly were classified into three groups when utilizing a technique for exploratory factor analysis. The factors were comprised of (1) requirements for general facilities and activities, (2) requirements for facilities related to health and security, and (3) requirements for facilities related to physical exercise in the residential community. The results from the SEM showed the background of elderly people had a direct effect on their requirements for a residential community from various aspects. The results should lead to the formulation of policies for design and management of residential communities for the elderly in order to enhance quality of life as well as both the physical and mental health of the Thai elderly.

Keywords: elderly, environmental design, residential community, structural equation modeling

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4059 Math Word Problems: Context and Achievement

Authors: Irena Smetackova

Abstract:

The important part of school mathematics are word problems which represent the connection between school knowledge and life reality. To find the reasons why students consider word problems to be difficult, it is necessary to take into consideration the motivational settings, besides mathematical knowledge and reading skills. Our goal is to identify whether the familiar or unfamiliar context of math word problem influences solving success rate and if so, whether the reasons are motivational or cognitive. For this purpose, we conducted three steps study in group of fifty pupils 9-10 years old. In the first step, we asked pupils to create ‘the best’ word problems for entered numerical formula. The set of 19 word problems with different contexts were selected. In the second step, pupils were asked to evaluate (without solving) how they like each item and how easy it is for them. The 6 word problems with low preference and low estimated success rate were selected and combined with other 6 problems with high preference and success rate. In the third step, the same pupils were asked to solve the word problems. The analysis showed that pupils attitudes and solving toward word problems varied by the context. The strong gender patterns both in preferred contexts and in estimated success rates were identified however the real success rate did not differ so strongly. The success gap between word problems with and without preferred contexts were stronger than the gap between problems with and without real experience with the context. The hypothesis that motivational factors are more important than cognitive factors was confirmed.

Keywords: mathematics, context of reality, motivation, cognition, word problems

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4058 The Effectiveness of Insider Mediation for Sustainable Peace: A Case Study in Mindanao, the Philippines

Authors: Miyoko Taniguchi

Abstract:

Conflict and violence have prevailed over the last four decades in conflict-affected areas in Muslim Mindanao, despite the signing of several peace agreements between the Philippine government and Islamic separatist insurgents (the Moro National Liberation Front (MNLF) and the Moro Islamic Liberation Front (MILF)), and peacebuilding activities on the ground. In the meantime, the peace talks had been facilitated and mediated by international actors such as the Organization of Islamic Cooperation (OIC) and its member countries such as Indonesia, and Malaysia, and Japan. In 2014, both the Government of the Philippines (GPH) and the MILF finally reached a Comprehensive Peace Agreement (CAB) in 2014 under the Aquino III administration, though a Bangsamoro Basic Law (BBL) based on the CAB was not enacted at the Catholic-majority of the Philippine Congress. After a long process of deliberations at the Congress, Republic Act 11054, known as the Bangsamoro Organic Law (BOL), was enacted in 2018 under the Duterate administration. In the beginning, President Duterte adopted an 'inclusive approach' that involves the MILF, all factions of the MNLF, non-Islamized indigenous peoples, and other influential clan leaders to align all peace processes under a single Bangsamoro peace process. A notable difference from past administrations, there is an explicit recognition of all agreements and legislations based on the rights of each stakeholder. This created a new identity as 'Bangsamoro', the residents of Muslim Mindanao, enhancing political legitimacy. Besides, it should be noted an important role of 'insider mediators' -a platform for the Bangsamoro from diverse sectors attempting to work within their respective organizations in Moro society. Give the above background, this paper aims at probing the effectiveness of insider mediation as one of the alternative approaches for mediation in the peace process. For the objectives, this research uses qualitative methods such as process-tracing and semi-structured interviews from diverse groups of stakeholders at from the state to the regional level, including the government officials involved in peace process under the Presidential Office, rebels (MILF and MNLF), civil society organizations involved in lobbying and facilitating peace process, especially in the legislative process. The key outcomes and findings are that the Insider Mediators Group, formed in 2016, had taken on a significant role in facilitating the achievement of a wider consensus among stakeholders on major Moro issues such as BBL’s passing during the last administration to call for unity among the Bangsamoro. Most of its members are well-educated professionals affiliated with the MILF, the MNLF, and influential clans. One of the group’s biggest achievements has been the lobbying and provision of legal advice to legislators who were not necessarily knowledgeable about the peace process during the deliberation of the bicameral conference of the BBL, which eventually led to its passage. It can be concluded that in the long run, strengthening vertical and horizontal relations between the Moro society and the State and among the Moro peoples that can be viewed as a means to sustainable peace.

Keywords: insider mediation, Mindanao, peace process, Moro Islamic liberation front

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4057 Estimating Anthropometric Dimensions for Saudi Males Using Artificial Neural Networks

Authors: Waleed Basuliman

Abstract:

Anthropometric dimensions are considered one of the important factors when designing human-machine systems. In this study, the estimation of anthropometric dimensions has been improved by using Artificial Neural Network (ANN) model that is able to predict the anthropometric measurements of Saudi males in Riyadh City. A total of 1427 Saudi males aged 6 to 60 years participated in measuring 20 anthropometric dimensions. These anthropometric measurements are considered important for designing the work and life applications in Saudi Arabia. The data were collected during eight months from different locations in Riyadh City. Five of these dimensions were used as predictors variables (inputs) of the model, and the remaining 15 dimensions were set to be the measured variables (Model’s outcomes). The hidden layers varied during the structuring stage, and the best performance was achieved with the network structure 6-25-15. The results showed that the developed Neural Network model was able to estimate the body dimensions of Saudi male population in Riyadh City. The network's mean absolute percentage error (MAPE) and the root mean squared error (RMSE) were found to be 0.0348 and 3.225, respectively. These results were found less, and then better, than the errors found in the literature. Finally, the accuracy of the developed neural network was evaluated by comparing the predicted outcomes with regression model. The ANN model showed higher coefficient of determination (R2) between the predicted and actual dimensions than the regression model.

Keywords: artificial neural network, anthropometric measurements, back-propagation

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4056 The Use of Creativity to Nudge Students Into Heutagogy: An Implementation in Graduate Business Education

Authors: Ricardo Bragança, Tom Vinaimont

Abstract:

This paper discusses the introduction of processes of self-determined learning (heutagogy) into a graduate course on financial modeling, using elements of entangled pedagogy and Biggs’ constructive alignment. To encourage learners to take control of their own learning journey and develop critical thinking and problem-solving skills, each session in the course receives tailor-made media-enhanced pedagogical assets. The design of those assets specifically supports entangled pedagogy, which opposes technological or pedagogical determinism in support of the collaborative integration of pedagogy and technology. Media assets for each of the ten sessions in this course consist of three components. The first component in this three-pronged approach is a game-cut-like cinematographic representation that introduces the context of the session. The second component represents a character from an open-source-styled community that encourages self-determined learning. The third component consists of a character, which refers to the in-person instructor and also aligns learning outcomes and assessment tasks, using Biggs’ constructive alignment, to the cinematographic and open-source-styled component. In essence, the course's metamorphosis helps students apply the concepts they've studied to actual financial modeling issues. The audio-visual media assets create a storyline throughout the course based on gamified and real-world applications, thus encouraging student engagement and interaction. The structured entanglement of pedagogy and technology also guides the instructor in the design of the in-class interactions and directs the focus on outcomes and assessments. The transformation process of this graduate course in financial modeling led to an institutional teaching award in 2021. The transformation of this course may be used as a model for other courses and programs in many disciplines to help with intended learning outcomes integration, constructive alignment, and Assurance of Learning.

Keywords: innovative education, active learning, entangled pedagogy, heutagogy, constructive alignment, project based learning, financial modeling, graduate business education

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4055 Investigation of the Trunk Inclination Positioning Angle on Swallowing and Respiratory Function

Authors: Hsin-Yi Kathy Cheng, Yan-Ying JU, Wann-Yun Shieh, Chin-Man Wang

Abstract:

Although the coordination of swallowing and respiration has been discussed widely, the influence of the positioning angle on swallowing and respiration during feeding has rarely been investigated. This study aimed to investigate the timing and coordination of swallowing and respiration in different seat inclination angles, with liquid and bolus, to provide suggestions and guidelines for the design and develop a feedback-controlled seat angle adjustment device for the back-adjustable wheelchair. Twenty-six participants aged between 15-30 years old without any signs of swallowing difficulty were included. The combination of seat inclinations and food types was randomly assigned, with three repetitions in each combination. The trunk inclination angle was adjusted by a commercialized positioning wheelchair. A total of 36 swallows were done, with at least 30 seconds of rest between each swallow. We used a self-developed wearable device to measure the submandibular muscle surface EMG, the movement of the thyroid cartilage, and the respiratory status of the nasal cavity. Our program auto-analyzed the onset and offset of duration, and the excursion and strength of thyroid cartilage when it was moving, coordination between breathing and swallowing were also included. Variables measured include the EMG duration (DsEMG), swallowing apnea duration (SAD), total excursion time (TET), duration of 2nd deflection, FSR amplitude, Onset latency, DsEMG onset, DsEMG offset, FSR onset, and FSR offset. These measurements were done in four-seat inclination angles (5。, 15。, 30。, 45。) and three food contents (1ml water, 10ml water, and 5ml pudding bolus) for each subject. The data collected between different contents were compared. Descriptive statistics were used to describe the basic features of the data. Repeated measure ANOVAs were used to analyze the differences for the dependent variables in different seat inclination and food content combinations. The results indicated significant differences in seat inclination, mostly between 5。 and 45。, in all variables except FSR amplitude. It also indicated significant differences in food contents almost among all variables. Significant interactions between seat inclination and food contents were only found in FSR offsets. The same protocol will be applied to participants with disabilities. The results of this study would serve as clinical guidance for proper feeding positions with different food contents. The ergonomic data would also provide references for assistive technology professionals and practitioners in device design and development. In summary, the current results indicated that it is easier for a subject to lean backward during swallowing than when sitting upright and swallowing water is easier than swallowing pudding. The results of this study would serve as the clinical guidance for proper feeding position (such as wheelchair back angle adjustment) with different food contents. The same protocol can be applied to elderly participants or participants with physical disabilities. The ergonomic data would also provide references for assistive technology professionals and practitioners in device design and development.

Keywords: swallowing, positioning, assistive device, disability

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4054 Communication Barriers and Challenges for Accessing Autism Care: Conventional Versus Alternative Medicine

Authors: M. D. Antoine

Abstract:

Despite the widespread use of complementary and alternative medicine (CAM) for autistic children, little is known about the communication flow between the different parties involved in autism care (e.g., parents/caregivers, conventional providers, alternative practitioners). This study aimed to describe how communication occurs through the first year following an autism spectrum disorder (ASD) diagnosis to identify challenges and potential barriers to communication within the healthcare system in Ottawa, Canada. From an ecological perspective, we collected qualitative data through 12 semi-structured interviews with six parents/caregivers, three conventional providers (e.g., family doctor, neurodevelopmental pediatrician, psychologist), and three alternative practitioners (e.g., naturopath, occupational therapist, speech and language pathologist) operating in Ottawa. We interpreted the data using thematic analysis. Findings revealed communication challenges between the parents/caregivers and conventional providers while they experience better communication flow with fewer challenges in alternative care settings. However, parents/caregivers are the only links between the health professionals of both streams. From the five contexts examined: organizational, interpersonal, media, cultural, and political-legal, we found four themes (provider knowledge, care integration, flexible care, and time constraints) underlining specific barriers to communication flow between the parties involved in the care of autistic children. The increasing interest in alternative medicine is forcing changes in the healthcare system. Communications occur outside the norms making openings for better communication and information-sharing increasingly essential. Within the identified themes in the current study, the necessity for better communication between all parties involved in the care of autistic children is evident. More ASD and CAM-related training for providers would support effective parent/caregiver-provider communication. The findings of the current study contribute to a better understanding of the role of communication in the care management of autism, which has implications for effective autism care.

Keywords: alternative medicine, autism care management, autism spectrum disorder, conventional medicine, parent-provider communication

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4053 Deformation Severity Prediction in Sewer Pipelines

Authors: Khalid Kaddoura, Ahmed Assad, Tarek Zayed

Abstract:

Sewer pipelines are prone to deterioration over-time. In fact, their deterioration does not follow a fixed downward pattern. This is in fact due to the defects that propagate through their service life. Sewer pipeline defects are categorized into distinct groups. However, the main two groups are the structural and operational defects. By definition, the structural defects influence the structural integrity of the sewer pipelines such as deformation, cracks, fractures, holes, etc. However, the operational defects are the ones that affect the flow of the sewer medium in the pipelines such as: roots, debris, attached deposits, infiltration, etc. Yet, the process for each defect to emerge follows a cause and effect relationship. Deformation, which is the change of the sewer pipeline geometry, is one type of an influencing defect that could be found in many sewer pipelines due to many surrounding factors. This defect could lead to collapse if the percentage exceeds 15%. Therefore, it is essential to predict the deformation percentage before confronting such a situation. Accordingly, this study will predict the percentage of the deformation defect in sewer pipelines adopting the multiple regression analysis. Several factors will be considered in establishing the model, which are expected to influence the defamation defect severity. Besides, this study will construct a time-based curve to understand how the defect would evolve overtime. Thus, this study is expected to be an asset for decision-makers as it will provide informative conclusions about the deformation defect severity. As a result, inspections will be minimized and so the budgets.

Keywords: deformation, prediction, regression analysis, sewer pipelines

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4052 Summer STEM Institute in Environmental Science and Data Sciencefor Middle and High School Students at Pace University

Authors: Lauren B. Birney

Abstract:

Summer STEM Institute for Middle and High School Students at Pace University The STEM Collaboratory NYC® Summer Fellows Institute takes place on Pace University’s New York City campus during July and provides the following key features for all participants: (i) individual meetings with Pace faculty to discuss and refine future educational goals; (ii) mentorship, guidance, and new friendships with program leaders; and (iii) guest lectures from professionals in STEM disciplines and businesses. The Summer STEM Institute allows middle school and high school students to work in teams to conceptualize, develop, and build native mobile applications that teach and reinforce skills in the sciences and mathematics. These workshops enhance students’STEM problem solving techniques and teach advanced methods of computer science and engineering. Topics include: big data and analytics at the Big Data lab at Seidenberg, Data Science focused on social and environmental advancement and betterment; Natural Disasters and their Societal Influences; Algal Blooms and Environmental Impacts; Green CitiesNYC; STEM jobs and growth opportunities for the future; renew able energy and sustainable infrastructure; and climate and the economy. In order to better align the existing Summer STEM, Institute with the CCERS model and expand the overall network, Pace is actively recruiting new content area specialists from STEM industries and private sector enterprises to participate in an enhanced summer institute in order to1) nurture student progress and connect summer learning to school year curriculum, 2) increase peer-to-peer collaboration amongst STEM professionals and private sector technologists, and 3) develop long term funding and sponsorship opportunities for corporate sector partners to support CCERS schools and programs directly.

Keywords: environmental restoration science, citizen science, data science, STEM

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4051 Identification of Suitable Rainwater Harvesting Sites Using Geospatial Techniques with AHP in Chacha Watershed, Jemma Sub-Basin Upper Blue Nile, Ethiopia

Authors: Abrha Ybeyn Gebremedhn, Yitea Seneshaw Getahun, Alebachew Shumye Moges, Fikrey Tesfay

Abstract:

Rainfed agriculture in Ethiopia has failed to produce enough food, to achieve the increasing demand for food. Pinpointing the appropriate site for rainwater harvesting (RWH) have a substantial contribution to increasing the available water and enhancing agricultural productivity. The current study related to the identification of the potential RWH sites was conducted at the Chacha watershed central highlands of Ethiopia which is endowed with rugged topography. The Geographic Information System with Analytical Hierarchy Process was used to generate the different maps for identifying appropriate sites for RWH. In this study, 11 factors that determine the RWH locations including slope, soil texture, runoff depth, land cover type, annual average rainfall, drainage density, lineament intensity, hydrologic soil group, antecedent moisture content, and distance to the roads were considered. The overall analyzed result shows that 10.50%, 71.10%, 17.90%, and 0.50% of the areas were found under highly, moderately, marginally suitable, and unsuitable areas for RWH, respectively. The RWH site selection was found highly dependent on a slope, soil texture, and runoff depth; moderately dependent on drainage density, annual average rainfall, and land use land cover; but less dependent on the other factors. The highly suitable areas for rainwater harvesting expansion are lands having a flat topography with a soil textural class of high-water holding capacity that can produce high runoff depth. The application of this study could be a baseline for planners and decision-makers and support any strategy adoption for appropriate RWH site selection.

Keywords: runoff depth, antecedent moisture condition, AHP, weighted overlay, water resource

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4050 Functional Gene Expression in Human Cells Using Linear Vectors Derived from Bacteriophage N15 Processing

Authors: Kumaran Narayanan, Pei-Sheng Liew

Abstract:

This paper adapts the bacteriophage N15 protelomerase enzyme to assemble linear chromosomes as vectors for gene expression in human cells. Phage N15 has the unique ability to replicate as a linear plasmid with telomeres in E. coli during its prophage stage of life-cycle. The virus-encoded protelomerase enzyme cuts its circular genome and caps its ends to form hairpin telomeres, resulting in a linear human-chromosome-like structure in E. coli. In mammalian cells, however, no enzyme with TelN-like activities has been found. In this work, we show for the first-time transfer of the protelomerase from phage into human and mouse cells and demonstrate recapitulation of its activity in these hosts. The function of this enzyme is assayed by demonstrating cleavage of its target DNA, followed by detecting telomere formation based on its resistance to recBCD enzyme digestion. We show protelomerase expression persists for at least 60 days, which indicates limited silencing of its expression. Next, we show that an intact human β-globin gene delivered on this linear chromosome accurately retains its expression in the human cellular environment for at least 60 hours, demonstrating its stability and potential as a vector. These results demonstrate that the N15 protelomerse is able to function in mammalian cells to cut and heal DNA to create telomeres, which provides a new tool for creating novel structures by DNA resolution in these hosts.

Keywords: chromosome, beta-globin, DNA, gene expression, linear vector

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4049 Grading Fourteen Zones of Isfahan in Terms of the Impact of Globalization on the Urban Fabric of the City, Using the TOPSIS Model

Authors: A. Zahedi Yeganeh, A. Khademolhosseini, R. Mokhtari Malekabadi

Abstract:

Undoubtedly one of the most far-reaching and controversial topics considered in the past few decades, has been globalization. Globalization lies in the essence of the modern culture. It is a complex and rapidly expanding network of links and mutual interdependence that is an aspect of modern life; though some argue that this link existed since the beginning of human history. If we consider globalization as a dynamic social process in which the geographical constraints governing the political, economic, social and cultural relationships have been undermined, it might not be possible to simply describe its impact on the urban fabric. But since in this phenomenon the increase in communications of societies (while preserving the main cultural - regional characteristics) with one another and the increase in the possibility of influencing other societies are discussed, the need for more studies will be felt. The main objective of this study is to grade based on some globalization factors on urban fabric applying the TOPSIS model. The research method is descriptive - analytical and survey. For data analysis, the TOPSIS model and SPSS software were used and the results of GIS software with fourteen cities are shown on the map. The results show that the process of being influenced by the globalization of the urban fabric of fourteen zones of Isfahan was not similar and there have been large differences in this respect between city zones; the most affected areas are zones 5, 6 and 9 of the municipality and the least impact has been on the zones 4 and 3 and 2.

Keywords: grading, globalization, urban fabric, 14 zones of Isfahan, TOPSIS model

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4048 The Uptake of Reproductive Maternal Newborn and Child Healthcare in Gonji Kolela, Amhara Region, Ethiopia: A Qualitative Exploration of What Is on the Ground and What Could Be Helpful

Authors: Yan Ding, Fei Yan, Ji Liang, Hong Jiang, Xiaoguang Yang, Xu Qian

Abstract:

The health status of GonjiKolela District, Amhara Region, Ethiopia is below its national average, and a sub-project of China UK Global Health Support Programme (GHSP) is expected to increase the uptake of a suite of reproductive, maternal, newborn and child health (RMNCH) interventions there. To explore what is on the ground and what could be helpful for the uptake of RMNCH services in GonjiKolela, a qualitative study was performed as part of the baseline assessment before the implementation of the project. Nine key informants from GonjiKolela were interviewed with self-designed interview guides and they were from the district Health Office, health centers, health posts, women health development army (community volunteer groups), mothers of newborns, and also a gynecologist from the maternal and child health center which is the referral center for pregnant women for this project. The interview were transcribed into words and sorted with qualitative analysis software MAXqda. Content analysis was mainly used to analyze the data. The district health office, the health centers and the health posts all had focal persons taking care of the management and provision of RMNCH services, and RMNCH related indicators were recorded and reported at each level routinely. In addition, district government and administration at community/administrative village level kept a close eye on the reduction of maternal, neonatal and child mortality. Women Health Development Amy at household level supported health workers at community/administrative village level (called health extension workers) in tracing, recording and reporting pregnant women, newborn and under-five children,organizing events for health education, demonstrating and leading health promotion activities, and stimulating the utilization of RMNCH.

Keywords: Reproductive Maternal Newborn and Child Health, Health Care Utilization, Qualitative Study, Ethiopia

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4047 Rohingya Resettlement Roadblocks: Challenges and Potentials

Authors: Ishrat Zakia Sultana

Abstract:

The solution to the Rohingya crisis has become complicated than it was anticipated. Because of consistent persecution, ethnic cleansing, and genocide against the Rohingya in Burma, four major influxes of the Rohingya people took place to the neighboring country Bangladesh. After the latest influx of October 2016 and August 2017, the total number of Rohingya in Bangladesh stands somewhere between 900,000 to over one million, placing Bangladesh much ahead with the number of refugees compared to Dadaab and Kakuma in Kenya, Bidibidi in Uganda, and Zaatari in Jordan. While Bangladesh received recognition and appreciation for receiving such a large number of Rohingya, eventually finding a solution to the Rohingya crisis has become a serious problem. The host country and the Rohingya themselves long for repatriation, the most desired solution to the crisis. But going back to their own country is now almost an impossible matter due to the unwillingness of the Myanmar government. The other two options to the solution to Rohingya crisis – reintegration in the host country and third country resettlement – have drawn little attention until now. On the one hand, the geopolitical factors have been making the Rohingya crisis complex. On the other, the war and conflict between Russia-Ukraine and Palestine-Israel have lessening the importance of the Rohingya issue and been diverting the world’s attention from the Rohingya crisis. Clearly, without the support of international community, Bangladesh finds no sustainable way to repatriate 1.1 million Rohingya. Yet, possibilities of a third country resettlement remain unexplored. In the past few years, some countries have expressed interest in accepting the Rohingya as part of third country resettlement but the number they wanted to take is like a drop in the ocean. This paper examines the roadblocks for third country resettlement of the Rohingya. It aims to look at the underlying reasons for which international community is less interested in accepting the Rohingya as refugees. Is it the racial and religious identity of the Rohingya that are considered problematic to the resettlement process? In what ways geopolitical complexities affecting the resettlement issue? How do the Rohingya view third country resettlement? This paper looks for the answers to these questions. The paper is based on qualitative study conducted from 2016-2018 and 2021-2023 in Rohingya camps in Cox’s Bazar, Bangladesh. The camp management authority, the Rohingya themselves, and the NGOs working in the camp participated in the study.

Keywords: rohingya, refugee, resettlement, bangladesh

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4046 Preparation of Amla (Phyllanthus emblica) Powder Using Spray Drying Technique

Authors: Shubham Mandliya, Pooja Pandey, H. N. Mishra

Abstract:

Amla (Phyllanthus emblica), a plant of Euphorbiaceous is widely distributed in subtropical and tropical areas of China, India, Indonesia, and Malaysia. Amla is very high in vitamin C content. Spray drying of fruit juices represents another alternative way to improve the physicochemical stability and increase their shelf life. Samples of amla powder were produced using the spray drying method to investigate the effect of inlet temperatures and maltodextrin levels. The spray dryer model used was a laboratory scale dryer and samples were run at different temperatures and concentrations. The response surface methodology (RSM) was used to optimize the spray-drying process for the development of amla powder. The resultant powders were then analyzed for vitamin C, moisture, solubility and dispersibility. The spray dried amla powder contains higher amounts of vitamin C when compared to commercial fruit juice powders. SEM analysis revealed that lower maltodextrin levels and higher inlet air temperatures resulted in smaller but smoother particles. At lower temperature, vitamin C content is high as compared to higher temperature. Spray drying is an effective as well as an economic method which can be commercially used for making powder rather than by tray or solar drying as more fraction is retained with less cost.

Keywords: Amla powder, physiochemical properties, response surface methodology, spray drying

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4045 Evaluation of Hancornia speciosa Gomes Lyophilization at Different Stages of Maturation

Authors: D. C. Soares, J. T. S. Santos, D. G. Costa, A. K. S. Abud, T. P. Nunes, A. V. D. Figueiredo, A. M. de Oliveira Junior

Abstract:

Mangabeira (Hancornia speciosa Gomes), a native plant in Brazil, is found growing spontaneously in various regions of the country. The high perishability of tropical fruits such as mangaba, causes it to be necessary to use technologies that promote conservation, aiming to increase the shelf life of this fruit and add value. The objective of this study was to compare the mangabas lyophilisation curves behaviours with different sizes and maturation stages. The fruits were freeze-dried for a period of approximately 45 hours at lyophilizer Liotop brand, model L -108. It has been considered large the fruits between 38 and 58 mm diameter and small, between 23 and 28 mm diameter and the two states of maturation, intermediate and mature. Large size mangabas drying curves in both states of maturation were linear behaviour at all process, while the kinetic drying curves related to small fruits, independent of maturation state, had a typical behaviour of drying, with all the well-defined steps. With these results it was noted that the time of lyophilisation was suitable for small mangabas, a fact that did not happen with the larger one. This may indicate that the large mangabas require a longer time to freeze until reaches the equilibrium level, as it happens with the small fruits, going to have constant moisture at the end of the process. For both types of fruit were analysed water activity, acidity, protein, lipid, and vitamin C before and after the process.

Keywords: freeze dryer, mangaba, conservation, chemical characteristics

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4044 Impact of Mhealth Tools on Psycho-Social Predictors of Behaviour Regarding Contraceptive Use

Authors: Preeti Tiwari, Jay Wood, Duncan Babbage

Abstract:

Family planning plays a role in saving lives across the globe by preventing unwanted pregnancies. The purpose of this multidisciplinary research was to determine the impact of mHealth tools have on psychosocial determinants of behaviour for family planning. The present study examines a topic that is very relevant in times where human-technology interaction is at its peak. It is probably one of the first studies that have investigated the impact of mobile phone technology on the underlying mechanisms of behaviour change for family planning using primary data. To examine the association between exposure to mHealth tools and predictors of behaviour, data was collected from mHealth intervention areas in India. A post-intervention quasi-experimental study with a 2x2 factorial design was conducted among 831 men and women from the state of Bihar. The quantitative data analysis evaluated the extent of influence that predictors of behaviour (beliefs, social norms, perceived behaviour control, and outcome behaviour) have on a woman’s decisions about family planning. The results indicated an association between exposure to mHealth tools and improved communication about family planning among various family members after receiving health information from a health worker (H1). A relationship between exposure to mHealth tools and increased support women received from their husbands and extended family (mothers-in-law specifically) and peers (H2) was also found. A further result showed that knowledge about family planning was greater among users of family planning (H4). mHealth tools empower women to communicate with family members. This has important implications for developing mobile phone-based tools, as they can be used as a crucial communication channel that can be an effective method of increasing communication among family members about contraceptives. Thus, it can be implied that where women feel nervous talking about contraception, the successful application of mHealth tools can strengthen the interactivity of the health communication and could increase the likelihood of using contraception. However, while it may improve health communication that can inform health decisions, it may be insufficient on its own to cause behaviour change.

Keywords: contraceptive, e-health, psycho-social, women

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4043 Radar Fault Diagnosis Strategy Based on Deep Learning

Authors: Bin Feng, Zhulin Zong

Abstract:

Radar systems are critical in the modern military, aviation, and maritime operations, and their proper functioning is essential for the success of these operations. However, due to the complexity and sensitivity of radar systems, they are susceptible to various faults that can significantly affect their performance. Traditional radar fault diagnosis strategies rely on expert knowledge and rule-based approaches, which are often limited in effectiveness and require a lot of time and resources. Deep learning has recently emerged as a promising approach for fault diagnosis due to its ability to learn features and patterns from large amounts of data automatically. In this paper, we propose a radar fault diagnosis strategy based on deep learning that can accurately identify and classify faults in radar systems. Our approach uses convolutional neural networks (CNN) to extract features from radar signals and fault classify the features. The proposed strategy is trained and validated on a dataset of measured radar signals with various types of faults. The results show that it achieves high accuracy in fault diagnosis. To further evaluate the effectiveness of the proposed strategy, we compare it with traditional rule-based approaches and other machine learning-based methods, including decision trees, support vector machines (SVMs), and random forests. The results demonstrate that our deep learning-based approach outperforms the traditional approaches in terms of accuracy and efficiency. Finally, we discuss the potential applications and limitations of the proposed strategy, as well as future research directions. Our study highlights the importance and potential of deep learning for radar fault diagnosis. It suggests that it can be a valuable tool for improving the performance and reliability of radar systems. In summary, this paper presents a radar fault diagnosis strategy based on deep learning that achieves high accuracy and efficiency in identifying and classifying faults in radar systems. The proposed strategy has significant potential for practical applications and can pave the way for further research.

Keywords: radar system, fault diagnosis, deep learning, radar fault

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4042 Synergism in the Inquiry Lab: An Analysis of Time Targets and Achievement

Authors: John M. Basey, Clinton D. Francis, Maxwell B. Joseph

Abstract:

After gathering data from experimental procedures, inquiry-oriented-science labs often allow students the freedom to stay and complete the write up in class or leave lab early and complete the write up later. Teachers must decide whether to allow students this freedom to self-regulate this time. Student interviews have indicated four time-target strategies that may influence how students utilize this time: grade-target-A, grade-target-C, time-limited, and proficiency. The hypothesis tested was that variability in class composition relative to the four grade-target strategies has an impact on when students leave class, which in turn may influence their overall learning as exemplified by grades. Students were divided into the four indicated groups with a survey. Class composition and the GTA teaching the class had significant impacts on how long students stayed in class with class composition having the greatest impact. A factor analysis identified two factors. Factor 1 included classes with percentages of grade-target students opposite time-limited/proficiency students and explained 43% of the variance. Factor 2 included classes with percentages of grade-target-A/proficiency students opposite grade-target-C students and explained 33% of the variance. Students who stayed longer received significantly higher grades (P = 0.008) with no significant relationships between grade and Factor 1 or Factor 2 (P > 0.05). The time students stayed in class was significantly positively related to Factor 1 (P = 0.006) and significantly negatively related to Factor 2 (P = 0.008). These results support the hypothesis and indicate that teachers may want to know the composition of student-target strategies before deciding on how to have students allocate study time at the end of inquiry-oriented labs. According to these results, ideal classes for self-regulation have a high proportion of proficiency and time-limited students and a low proportion of grade-target students, or a high proportion of grade-target-A and proficiency students and a low proportion of grade-target-C students. Non-ideal classes for self-regulation were comprised of the inverse proportions.

Keywords: grades, inquiry lab design, synergism in student motivation, class composition

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4041 Adolescent Social Anxiety, School Satisfaction, and School Absenteeism; Findings from Young-HUNT3 and Norwegian National Education Data

Authors: Malik D. Halidu, Cathrine F. Moe, Tommy Haugan

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Purpose: The demand for effective school-based interventions in shaping adolescents' unmet mental health needs is growing. Grounding in the functional contextualism approach, this study investigates the role of school satisfaction (SS) in serving as a buffer to school absenteeism (SAB) among adolescents experiencing social anxiety (SA). Methods: A unique and large population-based sample of adolescents (upper secondary school pupils; n= 1864) from the Young-HUNT 3 survey dataset merged with the national educational registry from Norway. Moderation regression analysis was performed using Stata 17. Results: We find a statistically significant moderating role of school satisfaction on the relationship between social anxiety and school absenteeism (β=-0.109,p<0.01) among upper secondary school pupils. Among socially anxious adolescents associated with a higher perceived quality of school life, it functions as a buffer by reducing the positive relationship between SA and SAB. But, there was no statistically significant difference between social anxiety and school absenteeism for adolescents with low school satisfaction. Conclusion: Overall, the study's hypothesis model was statistically supported and contributes to the discourse that school satisfaction as a target of school-based interventions can effectively improve school outcomes (e.g., reduced absenteeism) among socially anxious pupils.

Keywords: social anxiety, school satisfaction, school absenteeism, Norwegian adolescent

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4040 Strengthening Facility-Based Systems to Improve Access to In-Patient Care for Sick Newborns in Brong Ahafo Region, Ghana

Authors: Paulina Clara Appiah, Kofi Issah, Timothy Letsa, Kennedy Nartey, Amanua Chinbuah, Adoma Dwomo-Fokuo, Jacqeline G. Asibey

Abstract:

Background: The Every Newborn Action Plan provides evidence–based interventions to end preventable deaths in high burden countries. Brong Ahafo Region is one of ten regions in Ghana with less than half of its district hospitals having sick newborn units. Facility-based neonatal care is not prioritized and under-funded, and there is also inadequate knowledge and competence to manage the sick. The aim of this intervention was to make available in–patient care for sick newborns in all 19 district hospitals through the strengthening of facility-based systems. Methods: With the development and dissemination of the National Newborn Strategy and Action Plan 2014-2018, the country was able to attract PATH which provided the region with basic resuscitation equipment, supported hospital providers’ capacity building in Helping Babies Breathe, Essential Care of Every Baby, Infection Prevention and Management and held a symposia on managing the sick newborn. Newborn advocacy was promoted through newborn champions at the facility and community levels. Hospital management was then able to mobilize resources from communities, corporate organizations and from internally generated funds; created or expanded sick newborn care units and provided essential medicines and equipment. Kangaroo Mother Care was initiated in 6 hospitals. Pediatric specialist outreach services initiated comprised telephone consultations, teaching ward rounds and participating in perinatal death audits meetings. Newborn data capture and management was improved through the provision and training on the use of standard registers provided from the national level. Results: From February 2015 to November 2017, hospitals with sick newborn units increased from 7 to 19 (37%-100%). 180 pieces each of newborn ventilation bags and masks size 0, 1 and penguin suction bulbs were distributed to the hospitals, in addition to 20 newborn mannequin sets and 90 small clinical reminder posters. 802 providers (96.9%) were trained in resuscitation, of which 96% were successfully followed up in 6 weeks, 91% in 6 months and 80% in 12 months post-training. 53 clinicians (65%) were trained and mentored to manage sick newborns. 56 specialist teaching ward rounds were conducted. Data completeness improved from 92.6% - 99.9%. Availability of essential medicines improved from 11% to 100%. Number of hospital cots increased from 116 to 248 (214%). Cot occupancy rate increased from 57.4% to 92.5%. Hospitals with phototherapy equipment increased from 0 to 12 (63%). Hospitals with incubators increased from 1 to 12 (5%-63%). Newborn deaths among admissions reduced from 6.3% to 5.4%. Conclusion: Access to in-patient care increased significantly. Newborn advocacy successfully mobilized resources required for strengthening facility –based systems.

Keywords: facility-based systems, Ghana, in-patient care, newborn advocacy

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4039 The Effect of Merger Transference on the Maintenance of a Narcissistic Patient with a History of Treatment Interruption with Previous Therapists

Authors: Mehravar Javid

Abstract:

This case study delves into the psychological complexities of a 33-year-old woman, the second of three children, whose upbringing under a critical mother and a high-expectation father has significantly shaped her psychological landscape. Exhibiting a blend of worthlessness and a grandiose self, her life is a constant struggle between idealizing her father and devaluing her mother and sisters, coupled with a fear of intimacy and a desire for merger. This internal conflict manifests in symptoms of depression, anxiety, and a pattern of forming and quitting multiple relationships, all driven by a deep-seated need for validation and approval. The therapeutic journey reveals her resistance to treatment, particularly when her defense mechanisms are challenged, reflecting a complex transference dynamic where she yearns for merger yet fears it. The treatment focuses on empathetically addressing her idealization and mirroring needs, allowing for autonomy while repairing communication gaps. This approach not only confronts her emotional deficits rooted in her family dynamics but also aids in her quest for self-identity, navigating through her feelings of emptiness, inferiority, and powerlessness. The study highlights the nuanced interplay of family influence on the development and maintenance of narcissistic traits, offering insights into the therapeutic strategies that can facilitate growth and self-awareness in similar cases.

Keywords: narcissistic personality disorder, merger transference, treatment interruption, case study, family dynamics

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