Search results for: early stopping

Authors: Wondale Getinet Alemu, Lillian Mwanri, Clemence Due, Telake Azale, Anna Ziersch

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Background: Mental illness is one of the most severe, chronic, and disabling public health problems that affect patients' Quality of life (QoL). Improving the QoL for people with mental illness is one of the most critical steps in stopping disease progression and avoiding complications of mental illness. Therefore, we aimed to assess the QoL and its determinants in patients with mental illness in outpatient clinics in Northwest Ethiopia in 2023. Methods: A facility-based cross-sectional study was conducted among people with mental illness in an outpatient clinic in Ethiopia. The sampling interval was decided by dividing the total number of study participants who had a follow-up appointment during the data collection period (2400) by the total sample size of 638, with the starting point selected by lottery method. The interviewer-administered WHOQOL BREF-26 tool was used to measure the QoL of people with mental illness. The domains and Health-Related Quality of Life (HRQoL) were identified. The indirect and direct effects of variables were calculated using structural equation modeling with SPSS-28 and Amos-28 software. A p-value of < 0.05 and a 95% CI were used to evaluate statistical significance. Results: A total of 636 (99.7%) participants responded and completed the WHOQOL-BREF questionnaire. The mean score of overall HRQoL of people with mental illness in the outpatient clinic was (49.6 ± 10 Sd). The highest QoL was found in the physical health domain (50.67 ±9.5 Sd), and the lowest mean QoL was found in the psychological health domain (48.41±10 Sd). Rural residents, drug nonadherence, suicidal ideation, not getting counseling, moderate or severe subjective severity, the family does not participate in patient care, and a family history of mental illness had an indirect negative effect on HRQoL. Alcohol use and psychological health domain had a direct positive effect on QoL. Furthermore, objective severity of illness, having low self-esteem, and having a history of mental illness in the family had both direct and indirect effects on QoL. Furthermore, sociodemographic factors (residence, educational status, marital status), social support-related factors (self-esteem, family not participating in patient care), substance use factors (alcohol use, tobacco use,) and clinical factors (objective and subjective severity of illness, not getting counseling, suicidal ideation, number of episodes, comorbid illness, family history of mental illness, poor drug adherence) directly and indirectly affected QoL. Conclusions: In this study, the QoL of people with mental illness was poor, with the psychological health domain being the most affected. Sociodemographic factors, social support-related factors, drug use factors, and clinical factors directly and indirectly, affect QoL through the mediator variables of physical health domains, psychological health domains, social relation health domains, and environmental health domains. In order to improve the QoL of people with mental illnesses, we recommend that emphasis be given to addressing the scourge of mental health, including the development of policy and practice drivers that address the above-identified factors.

Keywords: quality of life, mental wellbeing, mental illness, mental disorder, Ethiopia

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Authors: Muhammad Irfan

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The rise of radicalization within Islam has spawned a new era of global terror. The battlefield Successes of ISIS and the Taliban are fuelled by an ideological war waged, largely and successfully, in the media arena. This research will examine how Islamic extremist groups are using media modalities and populist narratives to influence migrant Muslim populations in Europe towards extremism. In 2014, ISIS shocked the world in exporting horrifically graphic forms of violence on social media. Their Muslim support base was largely disgusted and reviled. In response, they reconfigured their narrative by introducing populist 'hooks', astutely portraying the Muslim populous as oppressed and exploited by unjust, corrupt autocratic regimes and Western power structures. Within this crucible of real and perceived oppression, hundreds of thousands of the most desperate, vulnerable and abused migrants left their homelands, risking their lives in the hope of finding peace, justice, and prosperity in Europe. Instead, many encountered social stigmatization, detention and/or discrimination for being illegal migrants, for lacking resources and for simply being Muslim. This research will examine how Islamic extremist groups are exploiting the disenfranchisement of these migrant populations and using populist messaging on social media to influence them towards violent extremism. ISIS, in particular, formulates specific encoded messages for newly-arriving Muslims in Europe, preying upon their vulnerability. Violence is posited, as a populist response, to the tyranny of European oppression. This research will analyze the factors and indicators which propel Muslim migrants along the spectrum from resilience to violence extremism. Expected outcomes are identification of factors which influence vulnerability towards violent extremism; an early-warning detection framework; predictive analysis models; and de-radicalization frameworks. This research will provide valuable tools (practical and policy level) for European governments, security stakeholders, communities, policy-makers, and educators; it is anticipated to contribute to a de-escalation of Islamic extremism globally.

Keywords: populism, radicalization, de-radicalization, social media, ISIS, Taliban, shariah, jihad, Islam, Europe, political communication, terrorism, migrants, refugees, extremism, global terror, predictive analysis, early warning detection, models, strategic communication, populist narratives, Islamic extremism

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Authors: Christa Beyers

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Investing in the health of youth is essential for the well-being of society. If youth do not live a healthy life, the future of the global workforce and overall development of adolescents looks bleak given the challenges posed in this developmental stage. The idea of sexuality education at home and in our schools is a controversial and contentious subject, as many parents and teachers do not hold the same beliefs as to what content should be taught. Despite high incidence of HIV and STD infections, early school dropout and teen pregnancies, sexuality education has still not been given the recognition or importance it deserves. By giving youth a voice can lead to both behavioural and policy changes. This article is based on a literature review of sex and sexuality education from a social studies approach. This article argues that adults tend to teach from their own perspective, which does not meet the needs of youth, thereby ignoring the social aspects of sexual behaviour.

Keywords: sexuality education, adolescents, communication, cycle of socialization

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Authors: Azadeh Afrasyabi, Ali Khaleghi, Aliakbar Alijarahi

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Training at an early age is so important, because of tremendous changes in adolescence, including the formation of character, physical changes and other factors. One of the most sensitive sectors in this field is the children with a disability and are somehow special children who have trouble in communicating with their environment. One of the emerging technologies in the field of education that can be effectively profitable called augmented reality, where the combination of real world and virtual images in real time produces new concepts that can facilitate learning. The purpose of this paper is to propose an effective training method for special and disabled children based on augmented reality. Of course, in particular, the efficiency of augmented reality in teaching children with autism will consider, also examine the various aspect of this disease and different learning methods in this area.

Keywords: technology in education, augmented reality, special education, teaching methods

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Authors: Tomasz Balabanski, Anna Biedunkiewicz

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Research on basic bacteriological and physicochemical parameters conducted by state institutions (Provincial Sanitary and Epidemiological Station and District Sanitary and Epidemiological Station) are limited to bathing waters under constant sanitary and epidemiological supervision. Unfortunately, no routine or monitoring tests are carried out for the presence of microfungi. This also applies to beach sand used for recreational purposes. The purpose of the planned own research was to determine the diversity of the mycobiota present on supervised and unsupervised sandy beaches, on the shores of lakes, of municipal baths used for recreation. The research material consisted of microfungi isolated from April to October 2019 from sandy beaches of supervised and unsupervised lakes located within the administrative boundaries of the city of Olsztyn (North-Eastern Poland, Europe). Four lakes, out of the fifteen available (Tyrsko, Kortowskie, Skanda, and Ukiel), whose bathing waters are subjected to routine bacteriological tests, were selected for testing. To compare the diversity of the mycobiota composition on the surface and below the sand mixing layer, samples were taken from two depths (10 cm and 50 cm), using a soil auger. Micro-fungi from sand samples were obtained by surface inoculation on an RBC medium from the 1st dilution (1:10). After incubation at 25°C for 96-144 h, the average number of CFU/dm³ was counted. Morphologically differing yeast colonies were passaged into Sabouraud agar slants with gentamicin and incubated again. For detailed laboratory analyses, culture methods (macro- and micro-cultures) and identification methods recommended in diagnostic mycological laboratories were used. The conducted research allowed obtaining 140 yeast isolates. The total average population ranged from 1.37 × 10⁻² CFU/dm³ before the bathing season (April 2019), 1.64 × 10⁻³ CFU/dm³ in the season (May-September 2019), and 1.60 × 10⁻² CFU/dm³ after the end of the season (October 2019). More microfungi were obtained from the surface layer of sand (100 isolates) than from the deeper layer (40 isolates). Reported microfungi may circulate seasonally between individual elements of the lake ecosystem. From the sand/soil from the catchment area beaches, they can get into bathing waters, stopping periodically on the coastal phyllosphere. The sand of the beaches and the phyllosphere are a kind of filter for the water reservoir. The presence of microfungi with various pathogenicity potential in these places is of major epidemiological importance. Therefore, full monitoring of not only recreational waters but also sandy beaches should be treated as an element of constant control by appropriate supervisory institutions, allowing recreational areas for public use so that the use of these places does not involve the risk of infection. Acknowledgment: 'Development Program of the University of Warmia and Mazury in Olsztyn', POWR.03.05.00-00-Z310/17, co-financed by the European Union under the European Social Fund from the Operational Program Knowledge Education Development. Tomasz Bałabański is a recipient of a scholarship from the Programme Interdisciplinary Doctoral Studies in Biology and Biotechnology (POWR.03.05.00-00-Z310/17), which is funded by the 'European Social Fund'.

Keywords: beach, microfungi, sand, yeasts

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Authors: Andrea Bertocchi, Alessio Barnaba Di Fonzo, Davide Talarico, Simone Rivaroli, Jeff Konin

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The patient is a 89 years old male (180cm/85kg) retired notary former golfer with no past medical history. He describes a progressive ideomotor slowdown for 14 months. The disorder is characterized by short-term memory deficits and, for some months, also by unstable walking with a broad base with skidding and risk of falling at directional changes and urinary urgency. There were also episodes of aggression towards his wife and staff. At the time, the patient takes no prescribed medications. He has difficulty eating, dressing, and some problems with personal hygiene. In the initial visit, the patient was alert, cooperating, and performed simple tasks; however, he has a hearing impairment, slowed spontaneous speech, and amnestic deficit to the short story. Ideomotor apraxia is not present. He scored 20 points in the MMSE. From a motor function, he has deficits using Medical Research Council (MRC) 3-/5 in bilateral lower limbs and requires maximum assistance from sit to stand with existing premature fatigue. He’s unable to walk for about 1 month. Tremors and hypertonia are absent. BERG was unable to be administered, and BARTHEL was obtained 45/100. An Amyloid Angiopathy is suspected and then confirmed at the neurological examination. Therehabilitation objectives were the recovery of mobility and reinforcement of the UE/LE, especially legs, for recovery of standing and walking. The cognitive aspect was also an essential factor for the patient's recovery. The literature doesn’t demonstrate any particular studies regarding motor and cognitive rehabilitation on this pathology. Failing to manage his attention on exercise and tending to be disinterested and falling asleep constantly, we used golf-specific gestures to stimulate his mind to work and get results because the patient has memory recall of golf related movement. We worked for 4 months with a frequency of 3 sessions per week. Every session lasted for 45 minutes. After 4 months of work, the patient walked independently with the use of a stick for about 120 meters without stopping. MRC 4/5 AI bilaterally andpostural steps performed independently with supervision. BERG 36/56. BARTHEL 65/100. 6 Minutes Walking Test (6MWT), at the beginning, it wasn’t measurable, now, he performs 151,5m with Numeric Rating Scale 4 at the beginning and 7 at the end. Cognitively, he no longer has episodes of aggression, although the short-term memory and concentration deficit remains. Amyloid Angiopathy is a mix of motor and cognitive disorder. It is worth the thought that cerebral amyloid angiopathy manifests with functional deficits due to strokes and bleedings and, as such, has an important rehabilitation indication, as classical stroke is not associated with amyloidosis. Exploring the motor patterns learned at a young age and remained in the implicit and explicit memory of the patient allowed us to set up effective work and to obtain significant results in the short-middle term. Surely many studies will still be done regarding this pathology and its rehabilitation, but the importance of the cognitive sphere applied to the motor sphere could represent an important starting point.

Keywords: amyloid angiopathy, cognitive rehabilitation, golf, motor disorder

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Authors: Amir Ngah, Masita Abdul Jalil, Zailani Abdullah

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The aim of software maintenance is to maintain the software system in accordance with advancement in software and hardware technology. One of the early works on software maintenance is to extract information at higher level of abstraction. In this paper, we present the process of how to design an information extraction tool for software maintenance. The tool can extract the basic information from old program such as about variables, based classes, derived classes, objects of classes, and functions. The tool have two main part; the lexical analyzer module that can read the input file character by character, and the searching module which is user can get the basic information from existing program. We implemented this tool for a patterned sub-C++ language as an input file.

Keywords: extraction tool, software maintenance, reverse engineering, C++

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Authors: Samantha J. Hall, Luke Taylor, Kenneth I. Cumming, Jakki Bardsley, Scott S. P. Wildman

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Medway School of Pharmacy – a joint collaboration between the University of Kent and the University of Greenwich – is a large school of pharmacy in the United Kingdom. The school primarily delivers the accredited Master or Pharmacy (MPharm) degree programme. Reportedly, some students may feel isolated from the larger student body that extends across four separate campuses, where a diverse range of academic subjects is delivered. In addition, student engagement has been noted as being limited in some areas, as evidenced in some cases by poor attendance at some lectures. In January 2015, the University of Kent launched a new initiative dedicated to Equality, Diversity and Inclusivity (EDI). As part of this project, Medway School of Pharmacy employed ‘Student Success Project Officers’ in order to analyse past and present school data. As a result, initiatives have been implemented to i) negate disparities in attainment and ii) increase engagement, particularly for Black, Asian and Minority Ethnic (BAME) students which make up for more than 80% of the pharmacy student cohort. Social media platforms are prevalent, with global statistics suggesting that they are most commonly used by females between the ages of 16-34. Student focus groups held throughout the academic year brought to light the school’s need to use social media much more actively. Prior to the EDI initiative, social media usage for Medway School of Pharmacy was scarce. Platforms including: Facebook, Twitter, Instagram, YouTube, The Student Room and University Blogs were either introduced or rejuvenated. This action was taken with the primary aim of increasing student engagement. By using a number of varied social media platforms, the university is able to capture a large range of students by appealing to different interests. Social media is being used to disseminate important information, promote equality and diversity, recognise and celebrate student success and also to allow students to explore the student life outside of Medway School of Pharmacy. Early data suggests an increase in lecture attendance, as well as greater evidence of student engagement highlighted by recent focus group discussions. In addition, students have communicated that active social media accounts were imperative when choosing universities for 2015/16. It allows students to understand more about the University and community prior to beginning their studies. By having a lively presence on social media, the university can use a multi-faceted approach to succeed in early engagement, as well as fostering the long term engagement of continuing students.

Keywords: engagement, social media, pharmacy, community

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Authors: Silas Webb, Joseph Hartland

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Background: Long-term retention of patients on ART has become a major health challenge in Sub-Saharan Africa (SSA). In 2010 a systematic review of 39 papers found that 30% of patients were no longer taking their ARTs two years after starting treatment. In the same review, it was noted that there was a paucity of data as to why patients become lost to follow-up (LTFU) in SSA. This project was performed in Mulanje Mission Hospital in Malawi as part of Swindon Academy’s Global Health eSSC. The HIV prevalence for Malawi is 10.3%, one of the highest rates in the world, however prevalence soars to 18% in the Mulanje. Therefore it is essential that patients at risk of being LTFU are identified early and managed appropriately to help them continue to participate in the service. Methodology: All patients on adult antiretroviral formulations at MMH, who were classified as ‘defaulters’ (patients missing a scheduled follow up visit by more than two months) over the last 12 months were included in the study. Demographic varibales were collected from Mastercards for data analysis. A comparison group of patients currently not lost to follow up was created by using all of the patients who attended the HIV clinic between 18th-22nd July 2016 who had never defaulted from ART. Data was analysed using the chi squared (χ²) test, as data collected was categorical, with alpha levels set at 0.05. Results: Overall, 136 patients had defaulted from ART over the past 12 months at MMH. Of these, 43 patients had missing Mastercards, so 93 defaulter datasets were analysed. In the comparison group 93 datasets were also analysed and statistical analysis done using Chi-Squared testing. A higher proportion of men in the defaulting group was noted (χ²=0.034) and defaulters tended to be younger (χ²=0.052). 94.6% of patients who defaulted were taking Tenofovir, Lamivudine and Efavirenz, the standard first line ART therapy in Malawi. The mean length of time on ART was 39.0 months (RR: -22.4-100.4) in the defaulters group and 47.3 months (RR: -19.71-114.23) in the control group, with a mean difference of 8.3 less months in the defaulters group (χ ²=0.056). Discussion: The findings in this study echo the literature, however this review expands on that and shows the demographic for the patient at most risk of defaulting and being LTFU would be: a young male who has missed more than 4 doses of ART and is within his first year of treatment. For the hospital, this data is important at it identifies significant areas for public health focus. For instance, fear of disclosure and stigma may be disproportionately affecting younger men, so interventions can be aimed specifically at them to improve their health outcomes. The mean length of time on medication was 8.3 months less in the defaulters group, with a p-value of 0.056, emphasising the need for more intensive follow-up in the early stages of treatment, when patients are at the highest risk of defaulting.

Keywords: anti-retroviral therapy, ART, HIV, lost to follow up, Malawi

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Authors: Lucia Antonela Mitidieri

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This research analyzes the application of a model of settlements management based on networks of territorial integration that advocates planning as a cyclical and participatory process that engages early on with civic society, the private sector and the state. Through qualitative methods such as participant observation, interviews with snowball technique and an active research on territories, concrete results of community empowerment are obtained from the promotion of productive enterprises and community spaces of encounter and exchange. Studying the cultural and organizational dimensions of empowerment allows building indicators such as increase of capacities or community cohesion that can lead to support local governments in achieving sustainable urban development for a reduction of urban poverty.

Keywords: community spaces, empowerment, network urbanism, participatory process

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Authors: Angela T. H. Kwan, Saman Arfaie, Joseph Therriault, Zahra Azizi, Firoza Z. Lussier, Cecile Tissot, Mira Chamoun, Gleb Bezgin, Stijn Servaes, Jenna Stevenon, Nesrine Rahmouni, Vanessa Pallen, Serge Gauthier, Pedro Rosa-Neto

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Alzheimer’s disease (AD) can be detected in living people using in vivo biomarkers of amyloid-β (Aβ) and tau, even in the absence of cognitive impairment during the preclinical phase. [¹⁸F]-MK-6420 is a high affinity positron emission tomography (PET) tracer that quantifies tau neurofibrillary tangles, but its ability to predict cognitive changes associated with early AD symptoms, such as memory decline, is unclear. Here, we assess the prognostic accuracy of baseline [18F]-MK-6420 tau PET for predicting longitudinal memory decline in asymptomatic elderly individuals. In a longitudinal observational study, we evaluated a cohort of cognitively normal elderly participants (n = 111) from the Translational Biomarkers in Aging and Dementia (TRIAD) study (data collected between October 2017 and July 2020, with a follow-up period of 12 months). All participants underwent tau PET with [¹⁸F]-MK-6420 and Aβ PET with [¹⁸F]-AZD-4694. The exclusion criteria included the presence of head trauma, stroke, or other neurological disorders. There were 111 eligible participants who were chosen based on the availability of Aβ PET, tau PET, magnetic resonance imaging (MRI), and APOEε4 genotyping. Among these participants, the mean (SD) age was 70.1 (8.6) years; 20 (18%) were tau PET positive, and 71 of 111 (63.9%) were women. A significant association between baseline Braak I-II [¹⁸F]-MK-6240 SUVR positivity and change in composite memory score was observed at the 12-month follow-up, after correcting for age, sex, and years of education (Logical Memory and RAVLT, standardized beta = -0.52 (-0.82-0.21), p < 0.001, for dichotomized tau PET and -1.22 (-1.84-(-0.61)), p < 0.0001, for continuous tau PET). Moderate cognitive decline was observed for A+T+ over the follow-up period, whereas no significant change was observed for A-T+, A+T-, and A-T-, though it should be noted that the A-T+ group was small.Our results indicate that baseline tau neurofibrillary tangle pathology is associated with longitudinal changes in memory function, supporting the use of [¹⁸F]-MK-6420 PET to predict the likelihood of asymptomatic elderly individuals experiencing future memory decline. Overall, [¹⁸F]-MK-6420 PET is a promising tool for predicting memory decline in older adults without cognitive impairment at baseline. This is of critical relevance as the field is shifting towards a biological model of AD defined by the aggregation of pathologic tau. Therefore, early detection of tau pathology using [¹⁸F]-MK-6420 PET provides us with the hope that living patients with AD may be diagnosed during the preclinical phase before it is too late.

Keywords: alzheimer’s disease, braak I-II, in vivo biomarkers, memory, PET, tau

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Authors: Nada R. Abuknesha, John P. Morgan, Andrew J. Searle

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Information regarding post-mortem interval (PMI) in criminal investigations is vital to establish a time frame when reconstructing events. PMI is defined as the time period that has elapsed between the occurrence of death and the discovery of the corpse. Adipocere, commonly referred to as ‘grave-wax’, is formed when post-mortem adipose tissue is converted into a solid material that is heavily comprised of fatty acids. Adipocere is of interest to forensic anthropologists, as its formation is able to slow down the decomposition process. Therefore, analysing the changes in the patterns of fatty acids during the early decomposition process may be able to estimate the period of burial, and hence the PMI. The current study concerned the investigation of the fatty acid composition and patterns in buried pig fat tissue. This was in an attempt to determine whether particular patterns of fatty acid composition can be shown to be associated with the duration of the burial, and hence may be used to estimate PMI. The use of adipose tissue from the abdominal region of domestic pigs (Sus-scrofa), was used to model the human decomposition process. 17 x 20cm piece of pork belly was buried in a shallow artificial grave, and weekly samples (n=3) from the buried pig fat tissue were collected over an 11-week period. Marker fatty acids: palmitic (C16:0), oleic (C18:1n-9) and linoleic (C18:2n-6) acid were extracted from the buried pig fat tissue and analysed as fatty acid methyl esters using the gas chromatography system. Levels of the marker fatty acids were quantified from their respective standards. The concentrations of C16:0 (69.2 mg/mL) and C18:1n-9 (44.3 mg/mL) from time zero exhibited significant fluctuations during the burial period. Levels rose (116 and 60.2 mg/mL, respectively) and fell starting from the second week to reach 19.3 and 18.3 mg/mL, respectively at week 6. Levels showed another increase at week 9 (66.3 and 44.1 mg/mL, respectively) followed by gradual decrease at week 10 (20.4 and 18.5 mg/mL, respectively). A sharp increase was observed in the final week (131.2 and 61.1 mg/mL, respectively). Conversely, the levels of C18:2n-6 remained more or less constant throughout the study. In addition to fluctuations in the concentrations, several new fatty acids appeared in the latter weeks. Other fatty acids which were detectable in the time zero sample, were lost in the latter weeks. There are several probable opportunities to utilise fatty acid analysis as a basic technique for approximating PMI: the quantification of marker fatty acids and the detection of selected fatty acids that either disappear or appear during the burial period. This pilot study indicates that this may be a potential semi-quantitative methodology for determining the PMI. Ideally, the analysis of particular fatty acid patterns in the early stages of decomposition could be an additional tool to the already available techniques or methods in improving the overall processes in estimating PMI of a corpse.

Keywords: adipocere, fatty acids, gas chromatography, post-mortem interval

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Authors: Martin Hagan

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Teacher identity has been recognised as a crucial field of research which supports understanding of the ways in which teachers navigate the complexities of professional life in order to grow in competence, knowledge and practice. As a field of study, teacher identity is concerned with understanding: how identity is defined; how it develops; how teachers make sense of their emerging identity; and how the act of teaching is mediated through the individual teacher’s values, beliefs and sense of professional self. By comparing two particular, socially constructed learning contexts or ‘learning milieu’, one in Northern Ireland and the other in the United States of America, this study aims specifically, to gain better understanding of how teacher identity develops during the initial phase of teacher education. The comparative approach was adopted on the premise that experiences are constructed through interactive, socio-historical and cultural negotiations with others within particular environments, situations and contexts. As such, whilst the common goal is to ‘become’ a teacher, the nuances emerging from the different learning milieu highlight variance in discourse, priorities, practice and influence. A qualitative, interpretative research design was employed to understand the world-constructions of the participants through asking open-ended questions, seeking views and perspectives, examining contexts and eventually deducing meaning. Data were collected using semi structured interviews from a purposive sample of student teachers (n14) in either the first or second year of study in their respective institutions. In addition, a sample of teacher educators (n5) responsible for the design, organisation and management of the programmes were also interviewed. Inductive thematic analysis was then conducted, which highlighted issues related to: the participants’ personal dispositions, prior learning experiences and motivation; the influence of the teacher education programme on the participants’ emerging professional identity; and the extent to which the experiences of working with teachers and pupils in schools in the context of the practicum, challenged and changed perspectives on teaching as a professional activity. The study also highlights the varying degrees of influence exercised by the different roles (tutor, host teacher/mentor, student) within the teacher-learning process across the two contexts. The findings of the study contribute to the understanding of teacher identity development in the early stages of professional learning. By so doing, the research makes a valid contribution to the discourse on initial teacher preparation and can help to better inform teacher educators and policy makers in relation to appropriate strategies, approaches and programmes to support professional learning and positive teacher identity formation.

Keywords: initial teacher education, professional learning, professional growth, teacher identity

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Authors: Mohsen Bahrami, Banafsheh Nikmehr, Yueqiang Song, Anuradha Koduru, Ayse K. Vuruskan, Hongkun Lu, Tamer M. Yalcinkaya

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In recent years, we have witnessed an explosion of studies aimed at using a combination of artificial intelligence (AI) and time-lapse imaging data on embryos to improve IVF outcomes. However, despite promising results, no study has used a matched cohort of transferred embryos which only differ in pregnancy outcome, i.e., embryos from a single clinic which are similar in parameters, such as: morphokinetic condition, patient age, and overall clinic and lab performance. Here, we used time-lapse data on embryos with known pregnancy outcomes to see if the rich spatiotemporal information embedded in this data would allow the prediction of the pregnancy outcome regardless of such critical parameters. Methodology—We did a retrospective analysis of time-lapse data from our IVF clinic utilizing Embryoscope 100% of the time for embryo culture to blastocyst stage with known clinical outcomes, including live birth vs nonpregnant (embryos with spontaneous abortion outcomes were excluded). We used time-lapse data from 200 elective single transfer embryos randomly selected from January 2019 to June 2021. Our sample included 100 embryos in each group with no significant difference in patient age (P=0.9550) and morphokinetic scores (P=0.4032). Data from all patients were combined to make a 4th order tensor, and feature extraction were subsequently carried out by a tensor decomposition methodology. The features were then used in a machine learning classifier to classify the two groups. Major Findings—The performance of the model was evaluated using 100 random subsampling cross validation (train (80%) - test (20%)). The prediction accuracy, averaged across 100 permutations, exceeded 80%. We also did a random grouping analysis, in which labels (live birth, nonpregnant) were randomly assigned to embryos, which yielded 50% accuracy. Conclusion—The high accuracy in the main analysis and the low accuracy in random grouping analysis suggest a consistent spatiotemporal pattern which is associated with pregnancy outcomes, regardless of patient age and embryo morphokinetic condition, and beyond already known parameters, such as: early cleavage or early blastulation. Despite small samples size, this ongoing analysis is the first to show the potential of AI methods in capturing the complex morphokinetic changes embedded in embryo time-lapse data, which contribute to successful pregnancy outcomes, regardless of already known parameters. The results on a larger sample size with complementary analysis on prediction of other key outcomes, such as: euploidy and aneuploidy of embryos will be presented at the meeting.

Keywords: IVF, embryo, machine learning, time-lapse imaging data

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Authors: Tianle Yang

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As a common mental disorder, depression is a leading cause of various diseases worldwide. Early detection and treatment of depression can dramatically promote remission and prevent relapse. However, conventional ways of depression diagnosis require considerable human effort and cause economic burden, while still being prone to misdiagnosis. On the other hand, recent studies report that physical characteristics are major contributors to the diagnosis of depression, which inspires us to mine the internal relationship by neural networks instead of relying on clinical experiences. In this paper, neural networks are constructed to predict depression from physical characteristics. Two initialization methods are examined - Xaiver and Kaiming initialization. Experimental results show that a 3-layers neural network with Kaiming initialization achieves 83% accuracy.

Keywords: depression, neural network, Xavier initialization, Kaiming initialization

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Authors: Mom Bishwakarma

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This research traces out how the Dalit in Nepal evolved from the early 1950s to the current day, from invoking Dalit against caste discrimination through to the asserting proportional representation in state structures. The research focused most closely on the formation of Dalit association and resistance, as well as on the different struggles throughout this period. It then discusses the expansion of Dalit movement in NGOs, its internationalization and responses. The research sees that Dalit movement has been influenced by its network with the national and international civil rights movement particularly Dalit movement in India and argues that Dalit movement in Nepal have in many ways, challenged the orthodox based caste stratification for Dalit equality and justice. It can be seen that at the same time as Dalit participation was increasing, divisions by caste line also emerged. Rather reshaping the power structures, Dalit movement encircled into division and contentious politics.

Keywords: Dalit, equality, justice, movements, Nepal

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Authors: Rossana Mancini

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The charm of a ruin colonised by wild plants and flowers is part of Western culture. The relationship between ruins and vegetation involves a wide range of different fields of research. During the first phase of the research the most important writings and projects about this argument were investigated, to understand how the perception of the co-existence of ruins and vegetation has changed over time and to investigate the various different approaches that these different fields have adopted when tackling this issue. The paper presents some practical examples of projects carried out from the early 1900s on. The major result is that specifically regards conservation, the best attitude is the management of change, an inevitable process when it comes to the co-existence of ruins and nature and, particularly, ruins and vegetation. Limiting ourselves to adopting measures designed to stop, or rather slow down, the increasing level of entropy (and therefore disorder) may not be enough.

Keywords: ruins, vegetation, conservation, archaeology, architecture

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Authors: Frazer Kirk, Rohen Skiba, Pankaj Saxena

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The natural history of the QAV is poorly understood due to the exceeding rarity of the condition. Incidence rates vary between 0.00028-1%. Classically patients present with Aortic Regurgitation (AR) between 40-60 years of age experiencing palpitations, chest pain, or heart failure. (1, 2) Echocardiography is the mainstay of diagnosis for this condition; however, given the rarity of this condition, it can easily be overlooked, as demonstrated here. The case report that follows serves as a reminder of the condition to reduce the innate cognitive bias to overlook the diagnosis due to the availability heuristic. Intraoperative photography, echocardiographic and magnetic resonance imaging from this case for reference to demonstrate that while the diagnosis of Aortic regurgitation was recognized early, the valve morphology was underappreciated.

Keywords: quadricuspid aortic valve, cardiac surgery, echocardiography, congenital

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Authors: Denisa Mackova, Andrea Pokorna

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The management of postoperative pain is a meaningful part of quality care. The experience and knowledge of registered nurses in postoperative pain management can be influenced by local know-how. Therefore, the research helps to understand the cultural differences between two countries with the aim of evaluating the management of postoperative pain management among the nurses from the Czech Republic and the Kingdom of Saudi Arabia. Both countries have different procedures on managing postoperative pain and the research will provide an understanding of both the advantages and disadvantages of the procedures and also highlight the knowledge and experience of registered nurses in both countries. Between the Czech Republic and the Kingdom of Saudi Arabia, the expectation is for differing results in the usage of opioid analgesia for the patients postoperatively and in the experience of registered nurses with Patient Controlled Analgesia. The aim is to evaluate the knowledge and awareness of registered nurses and to merge the data with the postoperative pain management in the early postoperative period in the Czech Republic and the Kingdom of Saudi Arabia. Also, the aim is to assess the knowledge and experience of registered nurses by using Patient Controlled Analgesia and epidural analgesia treatment in the early postoperative period. The criteria for those providing input into the study, are registered nurses, working in surgical settings (standard departments, post-anesthesia care unit, day care surgery or ICU’s) caring for patients in the postoperative period. Method: Research is being conducted by questionnaires. It is a quantitative research, a comparative study of registered nurses in the Czech Republic and the Kingdom of Saudi Arabia. Questionnaire surveys were distributed through an electronic Bristol online survey. Results: The collection of the data in the Kingdom of Saudi Arabia has been completed successfully, with 550 respondents, 77 were excluded and 473 respondents were included for statistical data analysis. The outcome of the research is expected to highlight the differences in treatment through Patient Controlled Analgesia, with more frequent use in the Kingdom of Saudi Arabia. A similar assumption is expected for treatment conducted by analgesia. We predict that opioids will be used more regularly in the Kingdom of Saudi Arabia, whilst therapy through NSAID’s being the most common approach in the Czech Republic. Discussion/Conclusion: The majority of respondents from the Kingdom of Saudi Arabia were female registered nurses from a multitude of nations. We are expecting a similar split in gender between the Czech Republic respondents; however, there will be a smaller number of nationalities. Relevance for research and practice: Output from the research will assess the knowledge, experience and practice of patient controlled analgesia and epidural analgesia treatment. Acknowledgement: This research was accepted and affiliated to the project: Postoperative pain management, knowledge and experience registered nurses (Czech Republic and Kingdom of Saudi Arabia) – SGS05/2019-2020.

Keywords: acute postoperative pain, epidural analgesia, nursing care, patient controlled analgesia

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Authors: Deanne McArthur, Melinda Wall, Claire Hanlon, Dana Agnolin, Krista Davis, Melanie Dennis, Elizabeth Glidden, Anne Marie Smith, Claudette Thomson

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In Canada, as prevalence rates and severity of illness have increased among patients suffering from eating disorders, wait times have grown substantially. Patients in Canada often face wait times in excess of 12 months. It is known that delaying treatment for eating disorders contributes to poor patient outcomes and higher rates of symptom relapse. Improving interim services for adult patients awaiting outpatient treatment is a priority for an outpatient eating disorders clinic in Ontario, Canada. The clinical setting currently provides care for adults diagnosed with anorexia nervosa, bulimia nervosa and binge eating disorder. At present, the only support provided while patients are on the waitlist consists of communication with primary care providers regarding parameters for medical monitoring. The significance of this study will be to test the feasibility, acceptability and efficacy of an intervention to support adult patients awaiting outpatient eating disorder treatment for anorexia nervosa, bulimia nervosa and binge eating disorder. Methods: An intervention including psychoeducation, supportive resources, self-monitoring, and auxiliary referral will be pilot-tested with a group of patients in the summer of 2022 and detailed using a prospective cohort case study research design. The team will host patient focus groups in May 2022 to gather input informing the content of the intervention. The intervention will be pilot tested with newly-referred patients in June and July 2022. Patients who participate in the intervention will be asked to complete a survey evaluating the utility of the intervention and for suggestions, they may have for improvement. Preliminary findings describing the existing literature pertaining to waitlist interventions for patients with eating disorders, data gathered from the focus groups and early pilot testing results will be presented. Data analysis will continue throughout 2022 and early 2023 for follow-up publication and presentation in the summer of 2023. The aim of this study is to contribute to the body of knowledge pertaining to providing interim support to those patients waiting for treatment for eating disorders and, by extension, to improve outcomes for this population.

Keywords: eating disorders, waitlist management, intervention study, pilot test

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Authors: Rida Ahmad, Areej S. Habib, Sohail A. Dogar, Saqib H. Qazi

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Transverse testicular ectopia is a rare congenital disorder involving mal descent and mal-positioning of the testes, reported in the medical literature about 300 times. Many theories attempt to explain the failure of the testes to migrate to their correct location. While the age at presentation can vary; most cases present in early adolescents or late adulthood. It is often an incidental discovery made during an operative intervention, most commonly during hernia exploration. It can be isolated or present with a plethora of anomalies. We present the case of a 2-year-old male with transverse testicular ectopia who presented with vague abdominal pain. He was managed successfully with the Modified Ombredanne procedure and good outcome 6 months after the procedure.

Keywords: cryptorchidism, persistent Mullerian duct syndrome, transverse testicular ectopia, testicular mal-descent

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Authors: Nonso Ochinanwata, Patrick Oseloka Ezepue

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This paper explores the process of creating and capturing born-global firm opportunities. It reviews the key constructs that underpin the establishment of born-global firms in sub-Saharan Africa. These include entrepreneurial orientation, resources and capabilities, collaboration, and contextual influences. The paper discusses how individuals and entrepreneurs in sub-Saharan Africa can establish home-based born-global firms that seek early international markets from inception. The paper suggests that sub-Saharan African governments should make a favourable microeconomics policy that will enable entrepreneurs and firms to acquire some certain minimal resources and capabilities, in order to develop global products and services.

Keywords: born global-firms, collaboration, internationalisation, dynamic capabilities, entrepreneurship, sub-Saharan Africa

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Authors: Anna Romanova, Mojtaba Mahmoodian, Morteza A. Alani

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Concrete sewer pipes are known to suffer from a process of hydrogen sulfide gas induced sulfuric acid corrosion. This leads to premature pipe degradation, performance failure and collapses which in turn may lead to property and health damage. The above work reports on a field study undertaken in working sewer manholes where the parameters of effluent temperature and pH as well as ambient temperature and concentration of hydrogen sulfide were continuously measured over a period of two months. Early results suggest that effluent pH has no direct effect on hydrogen sulfide build up; on average the effluent temperature is 3.5°C greater than the ambient temperature inside the manhole and also it was observed that hydrogen sulfate concentration increases with increasing temperature.

Keywords: concrete corrosion, hydrogen sulfide gas, temperature, sewer pipe

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Authors: Faten Khanfir, Mohamed Tlili, Ali Medeb Hamrouni, Raki Selmi, M. S. Khalfi, Faten Ben Amor

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Introduction: dental implant failure is a major concern for the clinician and the patient. Objectives: The aim of our study is to investigate the way in which 100 Tunisian dentists carried implant treatment for their patients from the early phase of planning and selection of patients to the placement of the implant in order to look for the implant failure factors. Results: significant correlations were found between failure rates > 5 and their corresponding factors as the number of implants placed (p = 0.001<0, 05), smoking (0.046 <0.05), unbalanced diabetes (0.03<0.05), aseptic protocol (= 0.004< 0.05) and the drilling speed (0,002<0.05) Conclusion: It seems that the number of implant placed, smoking, diabetes, aseptic protocol, and the drilling speed may contribute to dental implant failure.

Keywords: failure, implants, survey, risk, osseointegration

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Authors: Neerja Meena, Paresh Sukhani

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Dandy walker malformation is a generalised disorder of mesenchymal development that affect both the cerebellum and overlying meninges. Classically dandy-walker malformation consists of a triad of- 1:vermian and hemispheric cerebellar hypoplasia 2:cystic dilatation of 4th ventricle 3: enlarged posterior fossa with the upward migration of tentorium(lambdoid- torcular inversion). Clinical presentation: four months old female child with hydrocephalus and neurological symptoms. Generally- early death is common in classic dandy walker malformation. However, if it is relatively mild and uncomplicated by other CNS anomalies, intelligence can be normal and neurologic deficits minimal. Usually, VP shunting is the treatment of choice for this hydrocephalus. Conclusion: MRI is the modality of choice to diagnose posterior fossa malformation. However, it can be ruled out through using during the antenatal check as the prognosis of this malformation is not good; it's better to diagnose it inutero.

Keywords: Dandy Walker, Mri, Earlydaignosis, Treatment

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Authors: Ibrahim A. Aref, Tarek El-Mihoub, Khadiga Ben Musa

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This paper presents Carrier Sense Multiple Access (CSMA) communication model based on SoC design methodology. Such model can be used to support the modelling of the complex wireless communication systems, therefore use of such communication model is an important technique in the construction of high performance communication. SystemC has been chosen because it provides a homogeneous design flow for complex designs (i.e. SoC and IP based design). We use a swarm system to validate CSMA designed model and to show how advantages of incorporating communication early in the design process. The wireless communication created through the modeling of CSMA protocol that can be used to achieve communication between all the agents and to coordinate access to the shared medium (channel).

Keywords: systemC, modelling, simulation, CSMA

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Authors: Betül Demirbağ, Nesrin Demir

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As a developmental period, early adulthood has a vital role in romantic relationships in young adult's life. lt's known that in this period, satisfaction of individual needs such as affiliation is essential for well-functioning and to be succeeded in sequent developmental task. Romantic relationships have an expected association with attachment style. But it's needed to get more information about indicators of romantic relationships in different cultural backgrounds. in this research it's aimed to investigate whether there is a relationship between romantic relationship beliefs and Ego identity status and also other possible indicators such as gender, age, socioeconomic status. Participants were undergraduate students training in various programs in Education Faculty in Adiyaman University. As data collection tool, Romantic Relationship Beliefs scale and Ego Identity Process Questionnaire which was adapted into Turkish were used. Results were discussed in the relevant literature.

Keywords: ego identity, romantic relationships, university counseling

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Authors: Şule Yanık, Hasan Gürgür

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It is thought that it is important for disabled children to have the opportunity to benefit preschool education that smoothens transition process to formal education, and for the constitution of a precondition for their success. Within this context, it is important for the disabled in Turkey to be evaluated medically firstly and then educational-wise in order for them to benefit early inclusive education. Thus, disabled people are both diagnosed in hospitals and at Guidance and Research Centers (GRC) attached to Ministry of Education educational-wise. It is seen that standard evaluation tools are used and evaluations are done by special education teachers (SET) in order for educational diagnosis and evaluation (EDAE) to be realized. The literature emphasizes the importance of informal evaluation tools as well as formal ones. According to this, it is thought that another party, besides students in EDAE process and SETs, is family, because families are primary care takers for their children, and that the most correct and real information can be obtained via families beside results of educational evaluation processes (EEP). It is thought that obtaining opinions of families during EEP is important to be able to exhibit the present EDAE activities in Turkey, materialize any existing problems, and increase quality of the process. Within this context, the purpose of this study is to exhibit experiences regarding EDAE processes of 10 families having preschool children with hearing loss (CHL). The process of research is designed to be descriptive based on qualitative research paradigms. Data were collected via semi-structured interview questions, and the themes were obtained. As a result, it is seen that families, after they realize the hearing loss of their children, do not have any information regarding the subject, and that they consult to an ear-nose-throat doctor or an audiologist for support. It is seen that families go to hospitals for medical evaluation which is a pre-requisite for benefiting early education opportunities. However, during this process, as some families do not have any experience of having a CHL, it is seen that they are late for medical evaluation and hearing aids. Moreover, families stated that they were directed to GRC via audiologists for educational evaluation. Families stated that their children were evaluated regarding language, academic and psychological development in proportion with their ages in GRC after they were diagnosed medically. However, families stated that EEP realized in GRC was superficial, short and lacked detail. It is seen that many families were not included in EEP process, whereas some families stated that they were asked questions because their children are too small to answer. Regarding the benefits of EEP for themselves and their children, families stated that GRC had to give a report to them for benefiting the free support of Special Education and Rehabilitation Center, and that families had to be directed to inclusive education. As a result, it is seen that opinions of families regarding EDAE processes at GRC indicate inefficiency of the process as it is short and superficial, regardless being to the point.

Keywords: children with hearing loss, educational diagnosis and evaluation, guidance and research center, inclusion

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Authors: Nazish Badar

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In early 2009, Pandemic type A (H1N1) Influenza virus emerged globally. Since then, it has continued circulation causing considerable morbidity and mortality. The purpose of this study was to evaluate the evolutionary changes in Influenza A (H1N1) pdm09 viruses from 2009-15 and their relevance with the current vaccine viruses. Methods: Respiratory specimens were collected with influenza-like illness and Severe Acute Respiratory Illness. Samples were processed according to CDC protocol. Sequencing and phylogenetic analysis of Haemagglutinin (HA) and neuraminidase (NA) genes was carried out comparing representative isolates from Pakistan viruses. Results: Between Jan2009 - Feb 2016, 1870 (13.2%) samples were positive for influenza A out of 14086. During the pandemic period (2009–10), Influenza A/ H1N1pdm 09 was the dominant strain with 366 (45%) of total influenza positives. In the post-pandemic period (2011–2016), a total of 1066 (59.6%) cases were positive Influenza A/ H1N1pdm 09 with co-circulation of different Influenza A subtypes. Overall, the Pakistan A(H1N1) pdm09 viruses grouped in two genetic clades. Influenza A(H1N1)pdm09 viruses only ascribed to Clade 7 during the pandemic period whereas viruses belong to clade 7 (2011) and clade 6B (2015) during the post-pandemic years. Amino acid analysis of the HA gene revealed mutations at positions S220T, I338V and P100S specially associated with outbreaks in all the analyzed strains. Sequence analyses of post-pandemic A(H1N1)pdm09 viruses showed additional substitutions at antigenic sites; S179N,K180Q (SA), D185N, D239G (CA), S202A (SB) and at receptor binding sites; A13T, S200P when compared with pandemic period. Substitution at Genetic markers; A273T (69%), S200P/T (15%) and D239G (7.6%) associated with severity and E391K (69%) associated with virulence was identified in viruses isolated during 2015. Analysis of NA gene revealed outbreak markers; V106I (23%) among pandemic and N248D (100%) during post-pandemic Pakistan viruses. Additional N-Glycosylation site; HA S179N (23%), NA I23T(7.6%) and N44S (77%) in place of N386K(77%) were only found in post-pandemic viruses. All isolates showed histidine (H) at position 275 in NA indicating sensitivity to neuraminidase inhibitors. Conclusion: This study shows that the Influenza A(H1N1)pdm09 viruses from Pakistan clustered into two genetic clades, with co-circulation of some variants. Certain key substitutions in the receptor binding site and few changes indicative of virulence were also detected in post-pandemic strains. Therefore, it is imperative to continue monitoring of the viruses for early identification of potential variants of high virulence or emergence of drug-resistant variants.

Keywords: Influenza A (H1N1) pdm09, evolutionary analysis, post pandemic period, Pakistan

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Authors: Farah Al Zaabi, Sarah Amrani

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Complex regional pain syndrome (CRPS) is a chronic pain condition that develops in an extremity following a fracture, soft tissue injury, or surgery. It is a neuropathic pain disorder that is accompanied by the characteristic skin manifestations that are needed for the diagnosis. We report the case of a 30 year old male, who has findings consistent with CRPS and has been followed for over two years by multiple specialties within the healthcare system without obtaining a diagnosis. The symptoms he presented with were treated based on the specialty he was seeing, rather than unified and recognized as a single disease process. Our case highlights the complexity of chronic pain, which can sometimes present with skin manifestations, and the importance of involving a pain specialist early for both the medical and physical recovery of CRPS patients.

Keywords: complex regional pain syndrome, chronic pain, skin changes of CRPS, dermatological manifestions of CRPS

Procedia PDF Downloads 154