Search results for: knowledge management best practice

Authors: Wa`d Odeh, Alon Tal, Alfred Abed Rabbo, Nader Al Khatib, Shai Arnon

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The presence of endocrine disrupting compounds (EDCs) in raw sewage and effluents from wastewater treatment plants (WWTPs) has been increasingly studied in the last few decades. Higher risks are said to characterize situations where raw sewage streams are found to be flowing, or where partial and inadequate wastewater treatment exists. Such conditions are prevalent in the West Bank area of Palestine. To our knowledge, no previous data concerning the occurrence and fate of EDCs in the aquatic environment has ever been systematically evaluated in the region. Hence, the main objective of this study was to identify the occurrence and concentrations of major EDCs in raw sewage, wastewater effluents produced by treatment plants and in the receiving environments, including streams and groundwater in the West Bank, Palestine. Water samples were collected and analyzed for four times during the years of 2013 and 2014. Two large-scale conventional activated sludge WWTPs, two wastewater watercourses, one naturally perennial stream, and five groundwater locations close to wastewater sources were sampled and analyzed by GC/MS following EPA methods (525.2). Five EDCs (estriol, estrone, testosterone, bisphenol A, and octylphenol) were detected in trace concentrations (ng/l) in wastewater streams and at inputs to WWTPs. WWTPs were not able to achieve complete removal of all EDCs, and EDCs were still found in the effluents. In this regard, the most significant environmental estrogenic impact was due to estrone concentrations. Nevertheless, no EDCs were detected in groundwater. Yet, in order for effluents to be reused, significant improvement in treatment infrastructure should be a top priority for environmental managers in the region.

Keywords: endocrine disrupting compounds, raw sewage streams, conventional activated sludge WWTPs, WWTPs effluents

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Authors: Yung-Hui Tang, Yan-Chiou Ku, Li-Chi Huang

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Aim: The aim of this study is to explore the effect of the Humanoid Diagram Teaching (HDT) strategy on novice nurses’ care ability and retention rate. Methods: This study was a quasi-experimental study using two groups concurrently with repeat measurements sample consisted of 24 novice nurses (12 in each experimental and control group) in a medical center in southern Taiwan. Both groups all received regular training program (nursing standard techniques and practices, concept map, mini-CEX, CbD, and clinical education and training), and experimental group added the HDT program. The HDT strategy includes the contents of patients’ body humanoid drawing and discussion for 30 minutes each time, three times a week, and continually for four weeks. The effectiveness of ＨDT was evaluated by mini-CEX, CbD and clinical assessment and retention rate at the 3rd month and 6th month. Results: The novice nurses' care ability were examined, only CbD score in the control group was improved in the 3rd month and with statistical difference, p = .003. The mini-CEX and CbD in the experimental group were significantly improved in both the first and third month with statistical differences p = .00. Although mini-CEX and CbD in the experimental group were higher than the control group, but there was no significant difference p > .05. Retention rate of the experimental group in the third month and sixth month was significantly higher than the control group, and there was a statistically significant difference p < .05. Conclusions: The study reveals that HDT strategy can help novice nurses learning, enhancing their knowledge and technical capability, analytical skills in case-based caring, and retention. The HDT strategy can be served as an effective strategy for novice training for better nurse retention rate.

Keywords: humanoid diagram teaching strategy, novice nurses retention, teaching strategy of nurse retention, visual learning mode

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Authors: Phongkon Weerpiput

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This research study aimed to compare learning achievement between Jigsaw I and jigsaw IV techniques. The target group was 70 Thai major sophomores enrolled in a course entitled Foreign Language in Thai at the Faculty of Education, Suan Sunandha Rajabhat University. The research methodology was quasi-experimental design. A control group was given the Jigsaw I technique while an experimental group experienced the Jigsaw IV technique. The treatment content focused on Khmer loanwords in Thai language executed for a period of 3 hours per week for total of 3 weeks. The instruments included learning management plans and multiple-choice test items. The result yields no significant difference at level .05 between learning achievement of both techniques.

Keywords: Jigsaw I technique, Jigsaw IV technique, learning achievement, major sophomores

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Authors: N. Haj Salem, M. Belhadj, S. Ben Jomâa, S. Saadi, R. Dhouieb, A. Chadly

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Introduction: Sudden death in young is seen as a dramatic phenomenon requiring knowledge of its impact and determining their causes. Aim: We aim to study the epidemiological characteristics of sudden death in young, and to discuss the mechanism and the importance of autopsy in these situations. Material and methods: We performed a retrospective cohort study using autopsy data from the department of forensic medicine at the University Hospital of Fattouma Bourguiba, Monastir-Tunisia. A review of all autopsies performed during 23 years was done. In each case, clinical information and circumstances of death were obtained. We have included all sudden death in persons aged between 1 year and 35 years for the male and from one year to 45 years for female. We collected 312 cases of sudden death during the studied period. The collected data were processed using SPSS 20. The significance level was set at 0.05. Results: Thirty-two cases of cardiac ischemic sudden death have been collected. Myocardial infarction was the second cause of sudden death in young patients. There was a male predominance. The most affected subjects were aged between 25-45 years. The death occurred more frequently at rest. Coronary artery disease has been discovered in twenty-four cases (75%). A severe coronary artery disease was observed in two children with medical history of familial hypercholesterolemia. The myocardial infarction occurred in healthy coronary arteries in eight cases. An anomalous course of coronary arteries, in particular, myocardial bridging, was found in eight cases (25%). Toxicological screening was negative in all cases. Second cause of death was hypertrophic cardiomyopathy. Neurological and respiratory causes of death were implicated respectively in 10% and 15%. Conclusion: Identifying epidemiological characteristics of sudden death in this population is important for guiding approaches to prevention that must be based on dietary hygienic measures and the control of cardiovascular risk factors.

Keywords: autopsy, cardiac death, sudden death, young

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Authors: Madjid Karimirad

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Floating solar was not very well-known in the renewable energy field a decade ago; however, there has been tremendous growth internationally with a Compound Annual Growth Rate (CAGR) of nearly 30% in recent years. To reach the goal of global net-zero emission by 2050, all renewable energy sources including solar should be used. Considering that 40% of the world’s population lives within 100 kilometres of the coasts, floating solar in coastal waters is an obvious energy solution. However, this requires more robust floating solar solutions. This paper tries to enlighten the fundamental requirements in the design of floating solar for offshore installations from the hydrodynamic and offshore engineering points of view. In this regard, a closer look at dynamic characteristics, stochastic behaviour and nonlinear phenomena appearing in this kind of structure is a major focus of the current article. Floating solar structures are alternative and very attractive green energy installations with (a) Less strain on land usage for densely populated areas; (b) Natural cooling effect with efficiency gain; and (c) Increased irradiance from the reflectivity of water. Also, floating solar in conjunction with the hydroelectric plants can optimise energy efficiency and improve system reliability. The co-locating of floating solar units with other types such as offshore wind, wave energy, tidal turbines as well as aquaculture (fish farming) can result in better ocean space usage and increase the synergies. Floating solar technology has seen considerable developments in installed capacities in the past decade. Development of design standards and codes of practice for floating solar technologies deployed on both inland water-bodies and offshore is required to ensure robust and reliable systems that do not have detrimental impacts on the hosting water body. Floating solar will account for 17% of all PV energy produced worldwide by 2030. To enhance the development, further research in this area is needed. This paper aims to discuss the main critical design aspects in light of the load and load effects that the floating solar platforms are subjected to. The key considerations in hydrodynamics, aerodynamics and simultaneous effects from the wind and wave load actions will be discussed. The link of dynamic nonlinear loading, limit states and design space considering the environmental conditions is set to enable a better understanding of the design requirements of fast-evolving floating solar technology.

Keywords: floating solar, offshore renewable energy, wind and wave loading, design space

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Authors: Eyal Rosen

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This study is aimed to report a possible effect of the presence of dental implants on the development of crown or root fractures in adjacent natural teeth. A series of 26 cases of teeth diagnosed with crown or root fractures following the placement of adjacent dental implants is presented. In addition, a comprehensive systematic review of the literature was performed to detect other studies that evaluated this possible complication. The case series analysis revealed that all crown-fractured teeth were non-endodontically treated teeth (n=18), and all root fractured teeth were endodontically treated teeth (n=8). The time from implant loading to the diagnosis of a fracture in an adjacent tooth was longer than 1 year in 78% of cases. The majority of crown or root fractures occurred in female patients, over 50 years of age, with an average age of 59 in the crown fractures group, and 54 in the root fractures group. Most of the patients received 2 or more implants. Nine (50%) of the teeth with crown fracture were molars, 7 (39%) were mandibular premolars, and 2 (11%) were incisor teeth. The majority of teeth with root fracture were premolar or mandibular molar teeth (6 (75%)). The systematic review of the literature did not reveal additional studies that reported on this possible complication. To the best of the author’s knowledge this case series, although limited in its extent, is the first clinical report of a possible serious complication of implants, associated fractures in adjacent endodontically and non-endodontically treated natural teeth. The most common patient profile found in this series was a woman over 50 years of age, having a fractured premolar tooth, which was diagnosed more than 1 year after reconstruction that was based on multiple adjacent implants. Additional clinical studies are required in order to shed light on this potential serious complication.

Keywords: complications, dental implants, endodontics, fractured teeth

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Authors: Sally Heyeon Hwang

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Within decision theory, there are normative principles that dictate how one should act in addition to empirical theories of actual behavior. As a normative guide to one’s actual behavior, evidential or causal decision-theoretic equations allow one to identify outcomes with maximal utility values. The choice that each person makes, however, will, of course, differ according to varying assignments of weight and probability values. Regarding these different choices, it remains a subject of considerable philosophical controversy whether individual subjects have the capacity to exercise free will with respect to the assignment of probabilities, or whether instead the assignment is in some way constrained. A version of this question is given a precise form in Richard Jeffrey’s assumption that free will is necessary for Newcomb’s paradox to count as a decision problem. This paper will argue, against Jeffrey, that decision theory does not require the assumption of libertarian freedom. One of the hallmarks of decision-making is its application across a wide variety of contexts; the implications of a background assumption of free will is similarly varied. One constant across the contexts of decision is that there are always at least two levels of choice for a given agent, depending on the degree of prior constraint. Within the context of Newcomb’s problem, when the predictor is attempting to guess the choice the agent will make, he or she is analyzing the determined aspects of the agent such as past characteristics, experiences, and knowledge. On the other hand, as David Lewis’ backtracking argument concerning the relationship between past and present events brings to light, there are similarly varied ways in which the past can actually be dependent on the present. One implication of this argument is that even in deterministic settings, an agent can have more free will than it may seem. This paper will thus argue against the view that a stable background assumption of free will or determinism in decision theory is necessary, arguing instead for a compatibilist decision theory yielding a novel treatment of Newcomb’s problem.

Keywords: decision theory, compatibilism, free will, Newcomb’s problem

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Authors: Anthony Schmiedeler

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Reliable measurements for body esteem and time perspective have been constructed to acquire additional knowledge into these two distinct and personal domains of individuals. The Body Esteem Scale (BES) assesses the multidimensional body self-esteems of males and females and produces a particular score. A higher BES score indicates an individual has strong positive feelings relating to particular aspects of the individual’s body. The Zimbardo Time Perspective Inventory (ZTPI) measures individuals’ time perspectives and identifies their dominant time perspective profiles. Higher scores in a time perspective profile, such as Past Positive (i.e., nostalgically remembering the past), suggest an individuals’ inclination toward that specific way of orienting oneself with respect to time. Both scales rely on measurements that are similarly grounded in personality traits and reveal valuable insight into individuals’ personalities. Studying the two scales could provide insight into a possible relationship and allow for a better comprehension and more nuanced understanding of the utilities of the instruments. In a completed study, 69 adults completed both the ZTPI and BES. Analyses show that adult females’ higher BES scores positively correlate with higher scores of the Past Positive and Present Hedonistic time perspective profiles of the ZTPI. Male participants also had higher overall BES scores positively correlate with the Present Hedonistic profile in addition to the Positive Future time perspective profile. The results of this study suggest that individuals with certain body esteem scores have a pattern of corresponding with certain time orientations. These correlations could help in explaining the rationales behind individuals’ varying levels of body esteem. With a foundation for better understanding of body esteem by incorporating these time perspectives, future research could be conducted to develop instruments that more accurately reflect individuals’ body esteem measurements.

Keywords: BES, body esteem, time perspective, ZTPI

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Authors: Frazer Kirk, Matthew Yong, Peter Williams, Andrie Strobel

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Pulmonary valve papillary fibroelastoma is an exceedingly rare pathology. The experience and literature regarding them are largely anecdotal and based on sporadic, single case reports. Throughout their known history, two features remain salient that they are classically asymptomatic and found incidentally. The demographic profile of those affected is unclear, as reports regarding those affected are mixed, and there is no clear gender or age predominance, although there is some suggestion of a predisposition to affect females. Nor has there been a well-structured epidemiological study of the entity. Interestingly they are becoming more common on peri-mortum examination. Here-after we describe our experience with a symptomatic presentation of pulmonary papillary fibroelastoma masquerading as a pulmonary embolism and its subsequent assessment and management, with intraoperative photography and echocardiography for reference.

Keywords: cardiac tumor, pulmonary valve, fibroelastoma, cardiac surgery

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Authors: Hamid Fallah

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Undoubtedly, flood is known as a natural disaster, and in practice, flood is considered the most terrible natural disaster in the world both in terms of loss of life and financial losses. From 1988 to 1997, about 390,000 people were killed by natural disasters in the world, 58% of which were related to floods, 26% due to earthquakes, and 16% due to storms and other disasters. The total damages in these 10 years were about 700 billion dollars, which were 33, 29, 28% related to floods, storms and earthquakes, respectively. In this regard, the worrisome point has been the increasing trend of flood deaths and damages in the world in recent decades. The increase in population and assets in flood plains, changes in hydro systems and the destructive effects of human activities have been the main reasons for this increase. During rain and snow, some of the water is absorbed by the soil and plants. A percentage evaporates and the rest flows and is called runoff. Floods occur when the soil and plants cannot absorb the rainfall, and as a result, the natural river channel does not have the capacity to pass the generated runoff. On average, almost 30% of precipitation is converted into runoff, which increases with snow melting. Floods that occur differently create an area called flood plain around the river. River floods are often caused by heavy rains, which in some cases are accompanied by snow melt. A flood that flows in a river without warning or with little warning is called a flash flood. The casualties of these rapid floods that occur in small watersheds are generally more than the casualties of large river floods. Coastal areas are also subject to flooding caused by waves caused by strong storms on the surface of the oceans or waves caused by underground earthquakes. Floods not only cause damage to property and endanger the lives of humans and animals, but also leave other effects. Runoff caused by heavy rains causes soil erosion in the upstream and sedimentation problems in the downstream. The habitats of fish and other animals are often destroyed by floods. The high speed of the current increases the damage. Long-term floods stop traffic and prevent drainage and economic use of land. The supports of bridges, river banks, sewage outlets and other structures are damaged, and there is a disruption in shipping and hydropower generation. The economic losses of floods in the world are estimated at tens of billions of dollars annually.

Keywords: flood, hydrological engineering, gis, dam, small hydropower, suitablity

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Authors: Joy Ghosh, Debasmita Biswas

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The road network of any area is the most important indicator of regional planning. For proper utilization of urban road networks, the structural parameters such as connectivity and accessibility should be analyzed and evaluated. This paper aims to explain the application of GIS on urban road network connectivity and accessibility analysis with a case study of Chandannagar City. This paper has been made to analyze the road network connectivity through various connectivity measurements like the total number of nodes and links, Cyclomatic Number, Alpha Index, Beta Index, Gamma index, Eta index, Pi index, Theta Index, and Aggregated Transport Score, Road Density based on existing road network in Chandannagar city in India. Accessibility is measured through the shortest Path Matrix, associate Number, and Shimbel Index. Various urban services, such as schools, banks, Hospitals, petrol pumps, ATMs, police stations, theatres, parks, etc., are considered for the accessibility analysis for each ward. This paper also highlights the relationship between urban land use/ land cover (LULC) and urban road network and population density using various spatial and statistical measurements. The datasets were collected through a field survey of 33 wards of the Chandannagar Municipal Corporation area, and the secondary data were collected through an open street map and satellite image of LANDSAT8 OLI & TIRS from USGS. Chandannagar was actually once a French colony, and at that time, various sort of planning was applied, but now Chandannagar city continues to grow haphazardly because that city is facing some problems; the knowledge gained from this paper helps to create a more efficient and accessible road network. Therefore, it would be suggested that some wards need to improve their connectivity and accessibility for the future growth and development of Chandannagar.

Keywords: accessibility, connectivity, transport, road network

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Authors: Macarena-Paz Celume, Sylvie Tordjman

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There is still no consensus regarding the differences between gifted and non-gifted students in relationship to their self-esteem and the impact that this might have on behavioral and emotional troubles. In fact, some studies present no difference between both groups or present gifted population having higher scores in self-esteem, while others indicate all the opposite, presenting lower self-esteem in gifted population, suggesting that self-esteem issues are probably due to the fact that gifted children who present low self-esteem might not consider their high Intellectual Quotient (IQ) as a positive characteristic, thus leading to behavioral or emotional troubles. According to the author's knowledge, there is poor evidence trying to understand self-esteem issues in troubled gifted and non-gifted students in France, also finding an important lack regarding the possible moderators that might influence self-esteem. This study aimed to validate the results of these samples, looking for age and sex moderators in order to present recent evidence for the study of self-esteem in troubled gifted students in France. This study analysed the data gathered in the past 12 years for troubled students attending to the National Centre for Assistance to High Potential of Children and Adolescents (CNAHP) in France comparing the results of gifted versus non-gifted population. Primary results showed no significant differences between the groups in global self-esteem (t=1,15 p < .25), consistent with correlation analysis that found no correlation between global self-esteem and total IQ for each of the groups (rgifted=.04, rnon-gifted=.-08). Nevertheless, an ANOVA analysis showed an important effect of giftedness over academic self-esteem even though no significant differences were found (t=1,8 p < .06). No significant differences between sex regarding global self-esteem in any of the groups were found. Nevertheless, non-gifted population showed a significant difference in physical self-esteem, being higher for boys than for girls (t=2.65 p < .01). Sex and age moderator analyses for self-esteem will be presented and discussed.

Keywords: children and adolescents, giftedness, self-esteem, troubled children and adolescents

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Authors: Easter Faasoo-Tuilagi

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Study abroad has become a significant aspect of the tertiary system for New Zealand tertiary institutions and has been having a valuable contribution to student achievement and completion rate. The purpose of this doctoral study was to explore the significance and value of study abroad at an individual (learner), institutional (university), and national (government) level, with a focus on Māori and Pasifika learners. Previous research had conducted on the values and benefits of study abroad; however, there is a gap in knowledge on how study abroad can contribute to the educational experience of Māori and Pasifika students in tertiary studies in New Zealand. This study’s main focus aimed to explore the current participation and history of involvement of Māori and Pasifika students with study abroad using the University of Auckland and the University of Otago as case studies. It analysed the experiences of Māori and Pasifika students who were interested in study abroad or have returned from a study abroad. This research also explored how study abroad had become a significant aspect of the tertiary system in New Zealand, focusing on Tertiary Education Strategies. These questions were analysed using a range of methodologies, including a literature review to review how various institutions and nations, in particular New Zealand, were approaching study abroad, semi-structured interviews with Māori and Pasifika students on their experiences expressing interest in study abroad, and case studies of current/ returning Māori and Pasifika students who have had a study abroad experience. The anticipated results from this research will address several gaps in the existing literature and provide ways to better support Māori and Pasifika students who want to have a study abroad experience. This study will also inform education policy at an institutional and national level to boost the achievement of Māori and Pasifika students aligning with the Tertiary Education Strategy priorities.

Keywords: study abroad, Māori and Pasifika learners, international education, tertiary education strategy

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Authors: Aliyaa Zaidan, Rayan Bahabri

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The twenty-first century revealed an accelerating change and intensifying complexity of communication technology. Online social networking engines have gained astounding recognition worldwide. The influence of those social media platforms on dentistry and dental students is not well established. Therefore, this study aimed to evaluate the impact of using social media on professional and profile level among dental students in Saudi Arabia. A cross-sectional study developed via online questionnaire concerning on social media usage and its effect on professional and profile level of dental students and dental interns from several universities in Saudi Arabia. A total of 296 dental students and dental interns in Saudi Arabia responded to the questionnaire. Ninety-eight percent of the participants usually use the social media on a regular basis. Most social media sites used among the participants were Snapchat, Instagram, and YouTube by 85%, 81%, 77% respectively. Forty-one percent of the participants agreed that using social media in the dental field is a necessity nowadays. Thirty-eight percent of participants agreed that using social media is an easy way to gain a reliable knowledge, while 43% agreed that social media will improve the quality of healthcare. Furthermore, 65% of the students deemed using social media for academic purposes will improve their performance. Fifty-five percent of the respondents often use social media tools to obtain information about subject or procedures related to the dental field. Regarding profile reputation of dental students, 40% of the respondents agreed that their profile information published on social networking websites, could be used by others to judge their level of professionalism. Male and female dental students both agreed that their reputation would be adversely affected by 37%,63%, respectively, if their social networking activity were viewed by members of the public. The discrepancy among student levels reveals that social media profile positively influence the acceptance to postgraduate programs (P= 0.01).

Keywords: dental students, professional, reputation, social media

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Authors: N. Liu, N. Tuah, D. Ying

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This research aims to identify and test whether serious games can help children learn and pick up healthy eating habits. The practical component takes the form of digitalizing an already existing educational board game called “All you can eat” (AYCE), designed with the nutritious subject matter in mind. This time with the added features of online playability, which will widen its availability and accessibility to reach more players compared to the physical iteration. The game will be deployed alongside the conducting of theoretical research, which also involves teachers leading children to play said digital version. The research methodology utilizes two experiments, such as handing out surveys to gather feedback from both the partners and students. The research was carried out in several countries, namely Brunei, Malaysia, and Taiwan. The results are to be used for validating the concept of “serious games,” particularly when tied to the health aspect of the players, which in this case were children. As for the research outcomes, they can be applied to a variety of serious games that are related to health topics more broadly and not simply limited to healthy eating habits alone, adopting a balanced combination of practical and theoretical considerations. The study will also help other researchers in the correlated fields of serious game development and pediatrics to better comprehend the needs of children. On the theoretical side, these findings can enable further technological advancements to be made possible, a case in point being more serious games, to provide the appropriate social support precisely on the matter of health-related issues. Not just individuals but rather communities could benefit from improved health and well-being as a result of the project, which, when done right, will potentially improve their quality of life and have fun while doing it. AYCE will be demonstrated to support a wide range of health issues as a result of this research case.

Keywords: culture heritage, digital games, digitalization, traditional religious culture

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Authors: Eric Gismondi, Aurelie Bigot-Clivot

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Endocrine disruptors (EDCs) are well known to disrupt the development and the reproduction of exposed organisms. Although this point has been studied in vertebrate models, the limited knowledge of the endocrine system of invertebrates makes the evaluation of EDCs effects difficult. However, invertebrates represent the major part of aquatic ecosystems, such as amphipods Gammaridea, which are crucial for their functioning (e.g., litter degradation, food resource). Moreover, gammarids are hosts of parasites such as vertically-transmitted microsporidia (microsporidia VT), which could be confounding factors in assessment of EDC effects. Indeed, some microsporidia VT could have endocrine effects by their own present in the host since it was observed for example, a feminization of juvenile males, which become phenotypic females. This work evaluated the impact of ethinylestradiol (EE₂, estrogenic), cyproterone acetate (CPA, anti-androgenic), 4-hydroxytamoxifen (4HT, anti-estrogenic) and 17α-methyltestosterone (17MT - androgenic), on the 20-hydroxyecdysone concentration (i.e. 20HE - molt process) and the vitellogenin gene expression (i.e. reproduction) in the freshwater amphipod Gammarus pulex, after a 96h laboratory exposure. In addition, the presence of microsporidia VT was verified in order to analyze the effect of this confounding factor. Results of this study shown that, although endocrine systems of invertebrates and vertebrates are different, EDCs proved in vertebrates could also affect biological functions hormonally controlled in invertebrates. Indeed, the molt process of crustaceans was disrupted in the first stage (i.e. 20-HE concentration) and therefore, could affect, at the long term, the population dynamic. In addition, it was observed that G. pulex was differently impacted according to the gender and parasitism, which underline the importance to take into account these confounding factors to better evaluate the EDCs impact on invertebrate populations.

Keywords: endocrine disruption, gammarus sp., molt, parasitism

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Authors: E. Rama Devi Jothilingam

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Diabetes mellitus is now one of the most common non communicable diseases globally. India leads the world with largest number of diabetic subjects earning the title "diabetes capital of the world". In order to reduce the mortality rate, a fuzzy expert system is designed to predict the severity of cardiac and renal problems of diabetic patients using fuzzy logic. Since uncertainty is inherent in medicine, fuzzy logic is used in this research work to remove the inherent fuzziness of linguistic concepts and uncertain status in diabetes mellitus which is the prime cause for the cardiac arrest and renal failure. In this work, the controllable risk factors "blood sugar, insulin, ketones, lipids, obesity, blood pressure and protein/creatinine ratio" are considered as input parameters and the "the stages of cardiac" (SOC)" and the stages of renal" (SORD) are considered as the output parameters. The triangular membership functions are used to model the input and output parameters. The rule base is constructed for the proposed expert system based on the knowledge from the medical experts. Mamdani inference engine is used to infer the information based on the rule base to take major decision in diagnosis. Mean of maximum is used to get a non fuzzy control action that best represent possibility distribution of an inferred fuzzy control action. The proposed system also classifies the patients with high risk and low risk using fuzzy c means clustering techniques so that the patients with high risk are treated immediately. The system is validated with Matlab and is used as a tracking system with accuracy and robustness.

Keywords: Diabetes mellitus, fuzzy expert system, Mamdani, MATLAB

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Authors: Ahmed Abdallatif

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Background: Patients with malignant germ cell tumors have age distribution in two peaks, with the first one during infancy and the second after the onset of puberty. Gonadal germ cell tumors are the most common malignant ovarian tumor in females aged below twenty years. Sacrococcygeal and retroperitoneal abdominal tumors usually presents in a large size before the onset of symptoms. Methods: Patients with pediatric germ cell tumors presenting to Children’s Cancer Hospital Egypt and National Cancer Institute Egypt from January 2008 to June 2011 Patients underwent stratification according to risk into low, intermediate and high risk groups according to children oncology group classification. Objectives: Assessment of the clinicopathologic features of all cases of pediatric germ cell tumors and classification of malignant cases according to their stage, and the primary site to low, intermediate and high risk patients. Evaluation of surgical management in each group of patients focusing on surgical approach, the extent of surgical resection according to each site, ability to achieve complete surgical resection and perioperative complications. Finally, determination of the three years overall and disease-free survival in different groups and the relation to different prognostic factors including the extent of surgical resection. Results: Out of 131 cases surgically explored only 26 cases had re exploration with 8 cases explored for residual disease 9 cases for remote recurrence or metastatic disease and the other 9 cases for other complications. Patients with low risk kept under follow up after surgery, out of those of low risk group (48 patients) only 8 patients (16.5%) shifted to intermediate risk. There were 20 patients (14.6%) diagnosed as intermediate risk received 3 cycles of compressed (Cisplatin, Etoposide and Bleomycin) and all high risk group patients 69patients (50.4%) received chemotherapy. Stage of disease was strongly and significantly related to overall survival with a poorer survival in late stages (stage IV) as compared to earlier stages. Conclusion: Overall survival rate at 3 three years was (76.7% ± 5.4, 3) years EFS was (77.8 % ±4.0), however 3 years DFS was much better (89.8 ± 3.4) in whole study group with ovarian tumors had significantly higher Overall survival (90% ± 5.1). Event Free Survival analysis showed that Male gender was 3 times likely to have bad events than females. Patients who underwent incomplete resection were 4 times more than patients with complete resection to have bad events. Disease free survival analysis showed that Patients who underwent incomplete surgery were 18.8 times liable for recurrence compared to those who underwent complete surgery, and patients who were exposed to re-excision were 21 times more prone to recurrence compared to other patients.

Keywords: extragonadal, germ cell tumors, gonadal, pediatric

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Authors: Silka Abyadati, Dadi Rusdiana, Enjang Akhmad Juanda

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This study aims to investigate the students’ mastery concepts enhancement between students who are studying by using Integrated Real-Life Video and Animation (IRVA) and students who are studying without using IRVA. The development of IRVA is conducted by five stages: Analyze, Design, Development, Implementation and Evaluation (ADDIE) based on constructivist for Rotational Dynamics material in Physics learning. A constructivist model-based learning used is Interpretation Construction (ICON), which has the following phases: 1) Observation, 2) Construction interpretation, 3) Contextualization prior knowledge, 4) Conflict cognitive, 5) Learning cognitive, 6) Collaboration, 7) Multiple interpretation, 8) Multiple manifestation. The IRVA is developed for the stages of observation, cognitive conflict and cognitive learning. The sample of this study consisted of 32 students experimental group and a control group of 32 students in class XI of the school year 2015/2016 in one of Senior High Schools Bandung. The study was conducted by giving the pretest and posttest in the form of 20 items of multiple choice questions to determine the enhancement of mastery concept of Rotational Dynamics. Hypothesis testing is done by using T-test on the value of N-gain average of mastery concepts. The results showed that there is a significant difference in an enhancement of students’ mastery concepts between students who are studying by using IRVA and students who are studying without IRVA. Students in the experimental group increased by 0.468 while students in the control group increased by 0.207.

Keywords: ADDIE, constructivist learning, Integrated Real-Life Video and Animation, mastery concepts, rotational dynamics

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Authors: Muhammad Mustafizur Rahaman

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Social business is a new concept in the field of Business Economics and Capitalist Economy. It has increased the importance in economic and social development in emerging economies. Professor Muhammad Yunus is the founding father of the notion. While conventional business underscores profit maximization as a core business principle, social business calls for addressing social problems at the expense of profit. This underlying principle gives social business advantageous position over conventional businesses to serve those who live at the bottom of the pyramid. It also poses grave challenges to the social business because social business sacrifices profit at one hand and seeks financial sustainability on the other. For the sake of its financial sustainability, the social business might increase the price of its product or service which might lower its social impact, thus, makes the business self-defeating. Therefore, social business should be more innovative in every business process including production, marketing, and management. Otherwise, the business is unlikely to be driven out from the society.

Keywords: innovativeness, self-defeat, social business, social problem

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Authors: Felicia Kikelomo Oluwalola

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The study was designed to identify the challenges to change and innovation in educational system in Nigeria. Educational institutions, like all other organizations, require constant monitoring, to identify areas for potential improvement. However, educational reforms are often not well-implemented. This results in massive wastage of finances, human resources, and lost potential. Educational institutions are organised on many levels, from the individual classroom under the management of a single teacher, to groups of classrooms supervised by a Head Teacher or Executive Teacher, to a whole-school structure, under the guidance of the principal. Therefore, there is need for changes and innovation in our educational system since we are in the era of computer age. In doing so, this paper examined the psychology of change, concept of change and innovation with suggested view points. Educational administrators and individuals should be ready to have the challenge of monitoring changes in technologies. Educational planners/policy makers should be encouraged to involve in change process.

Keywords: challenges, change, education, innovation

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Authors: Easa Almustanyir

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This study investigates the linguistic and thematic approach of translator Abdullah Khrief in the context of video translations on the X platform. The sample comprises 15 videos from Khrief's account, covering diverse content categories like science, religion, social issues, personal experiences, lifestyle, and culture. The analysis focuses on two aspects: language usage and thematic representation. Regarding language, the study examines the prevalence of English while considering the inclusion of French and German content, highlighting Khrief's multilingual versatility and ability to navigate cultural nuances. Thematically, the study explores the diverse range of topics covered, encompassing scientific, religious, social, and personal narratives, underscoring Khrief's broad subject matter expertise and commitment to knowledge dissemination. The study employs a mixed-methods approach, combining quantitative data analysis with qualitative content analysis. Statistical data on video languages, presenter genders, and content categories are analyzed, and a thorough content analysis assesses translation accuracy, cultural appropriateness, and overall quality. Preliminary findings indicate a high level of professionalism and expertise in Khrief's translations. The absence of errors across the diverse range of videos establishes his credibility and trustworthiness. Furthermore, the accurate representation of cultural nuances and sensitive topics highlights Khrief's cultural sensitivity and commitment to preserving intended meanings and emotional resonance.

Keywords: audiovisual translation, linguistic versatility, thematic diversity, cultural sensitivity, content analysis, mixed-methods approach

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Authors: Suprehatin Suprehatin

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Improving the participation of smallholder farmers in horticultural value chains to benefit from the rapidly growing demand for high-value agricultural products is one strategy for raising farm income. However, smallholder farmer participation in Indonesian horticultural value chains is under-researched. To address this knowledge gap, this study aims to describe the current status of horticultural crop adoption in Indonesia and analyze the motivations and dynamics of smallholder farmer participation in horticultural value chains: why some small farmers join these new and potentially profitable chains and continue their participation. This study also examines the characteristics of farmers who adopted and those who did not adopt a new horticultural crop with respect to the household (farmer), farm and institutional characteristics. The analysis was conducted using unique data from a 2013 survey of 960 Indonesian farmers on Java Island that produce a variety of agricultural products. Basic statistical analysis showed relatively low adoption rates (10%) of new horticultural crops amongst 960 selected Indonesian farmers with different decisions made in terms of number and timing of new horticultural crop adoption. Adopters were motivated mainly by higher profit, higher yield, and more cash opportunities. The result also showed that current low rates of horticultural crop adoption are associated with a variety of factors, such as lower levels of education among farmers, resource constraints, lack of information on horticultural crop production and low participation in farmer groups. These findings will be helpful for policymakers when designing policies and programs to promote greater participation of Indonesian smallholder farmers in horticultural value chains. In other words, a revitalisation of agricultural policy beyond staple food is important to seize potential benefits from the ongoing agricultural food market transformation.

Keywords: farmer adoption, high value, horticultural crops, Indonesia

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Authors: Ali A. Karakhan

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Stakeholders in the architecture, engineering, and construction (AEC) industry have been always searching for strategies to develop, design, and construct healthy and smart building projects. Healthy and smart building projects require that the building process including design and construction be altered and carefully implemented in order to bring about sustainable outcomes throughout the facility lifecycle. Healthy and smart building projects are expected to positively influence organizational success and facility performance across the project lifecycle leading to superior outcomes in terms of people, economy, and the environment. The present study aims to identify potential strategies that AEC organizations can implement to achieve healthy and smart building projects. Drivers and barriers for healthy and smart building features are also examined. The study findings indicate that there are three strategies to advance the development of healthy and smart building projects: (1) the incorporation of high-quality products and low chemical-emitting materials, (2) the integration of innovative designs, methods, and practices, and (3) the adoption of smart technology throughout the facility lifecycle. Satisfying external demands, achievement of a third-party certification, obtaining financial incentives, and a desire to fulfill professional duty are identified as the key drivers for developing healthy and smart building features; whereas, lack of knowledge and training, time/cost constrains, preference for/adherence to customary practices, and unclear business case for why healthy buildings are advantageous are recognized as the primary barriers toward a wider diffusion of healthy and smart building projects. The present study grounded in previous engineering, medical, and public health research provides valuable technical and practical recommendations for facility owners and industry professionals interested in pursuing sustainable, yet healthy and smart building projects.

Keywords: healthy buildings, smart construction, innovative designs, sustainable projects

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Authors: Johannes Gantner, Michael Held, Matthias Fischer

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The refurbishment of the building stock in terms of energy supply and efficiency is one of the major challenges of the German turnaround in energy policy. As the building sector accounts for 40% of Germany’s total energy demand, additional insulation is key for energy efficient refurbished buildings. Nevertheless the energetic benefits often the environmental and economic performances of insulation materials are questioned. The methods Life Cycle Assessment (LCA) as well as Life Cycle Costing (LCC) can form the standardized basis for answering this doubts and more and more become important for material producers due efforts such as Product Environmental Footprint (PEF) or Environmental Product Declarations (EPD). Due to increasing use of LCA and LCC information for decision support the robustness and resilience of the results become crucial especially for support of decision and policy makers. LCA and LCC results are based on respective models which depend on technical parameters like efficiencies, material and energy demand, product output, etc.. Nevertheless, the influence of parameter uncertainties on lifecycle results are usually not considered or just studied superficially. Anyhow the effect of parameter uncertainties cannot be neglected. Based on the example of an exterior wall the overall lifecycle results are varying by a magnitude of more than three. As a result simple best case worst case analyses used in practice are not sufficient. These analyses allow for a first rude view on the results but are not taking effects into account such as error propagation. Thereby LCA practitioners cannot provide further guidance for decision makers. Probabilistic analyses enable LCA practitioners to gain deeper understanding of the LCA and LCC results and provide a better decision support. Within this study, the environmental and economic impacts of an exterior wall system over its whole lifecycle are illustrated, and the effect of different uncertainty analysis on the interpretation in terms of resilience and robustness are shown. Hereby the approaches of error propagation and Monte Carlo Simulations are applied and combined with statistical methods in order to allow for a deeper understanding and interpretation. All in all this study emphasis the need for a deeper and more detailed probabilistic evaluation based on statistical methods. Just by this, misleading interpretations can be avoided, and the results can be used for resilient and robust decisions.

Keywords: uncertainty, life cycle assessment, life cycle costing, Monte Carlo simulation

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Authors: Zwelenkani Mdlalose

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From the moment Covid 19 was declared a pandemic it became clear that conspiracy theories would significantly impact our response to the crisis that the virus was to become. Central to the interest in conspiracy theories evoked by a pandemic is a more general concern for the impact they have on society and social harmony. The specific brand of Conspiracy Theory that is in question is not any and all theories about conspiracies but rather those conspiracy theories which contradict official accounts. For example, where the official account on the terrorist attacks of September 11 2001 is of a conspiracy involving 19 militants associated with the Islamic extremist group al-Qaeda against targets in the United States, the nature of conspiracy theory under study is the one contradicting this official account to the extent that its attributes the attacks not to al-Qaeda militants but to actors in the United States government itself. The study is not an investigation into the truth value of conspiracy theories but rather an attempt at observing the essential qualities of the type of belief that is belief in conspiracy theories compared to belief in official accounts provided by authoritative sources such as governments, experts and mainstream media. These qualities include the psychological, epistemic and socio-political foundations on which belief in conspiracy theories are established. Based on a foundational understanding of the sort of belief that are beliefs in conspiracy theories, we may then extrapolate implied ethical demands on both authoritative bodies and actors as well as believers in conspiracy theories. For example: in their unofficial ‘non-factual’ status, is there not some violation of epistemic right in the same way we observe in cases where people are prejudiced because of their religious beliefs? In other words, is there an epistemic injustice suffered by believers in conspiracy theories in the way their beliefs are rejected as illegitimate? Conversely, to what extent do believers bear an epistemic responsibility in their adoption of their beliefs in conspiracy theories. From this position, perhaps we can then develop responses to the problem that foster greater social harmony even in the midst of suspicion and distrust.

Keywords: conspiracy theories, subjugated knowledge, epistemic injustice, epistemic responsibility

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Authors: Birendra Mahato, Shiva Narayan Chaudhary

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Tharus are indigenous inhabitants of the Tarai, the narrow strip of flat and fertile land that lies at the foothills of the Himalayas. They have unique rituals, festivals, and music, while their clothes and ornaments are similar to some ethnic groups of India. After the control of malaria in the Terai between 1955 to 1965, (with the help of the U.S. Government, the WHO and the government of Nepal) the rate of in-migration skyrocketed, particularly of Nepal’s hill people, whose culture, along with the use of the Western education system, was gradually adopted by the Tharus. Among the many challenges, the Tharus face is their assimilation into the dominant Nepali culture. .The Tharus are thus under threat of slowly losing their ethnic identity and cultural values. In order to preserve the indigenous Tharu Culture, Tharu Cultural Museum, and Research Center. It is a community based non-governmental and non-profitable museum established in 2005 by Tharu intellectuals, traditional leaders and youths. The main goal of the museum is to preserve Tharu culture through different activities with direct and indirect involvement of community people. It aims to preserve arts, culture, handicrafts, and artifacts related to Indigenous Tharu People. Similarly, the museum displays an exhibition about the Tharu histories, lives, culture, and their indigenous knowledge and skills. The paper aims to demonstrate that community museums can be one of the key hubs for the preservation of culture with the collection and promotion of cultural objects, artifacts, and intangible cultural heritages. The preservation of culture not only has contributed to establishing their ethnic identity but also has contributed to establishing their recognition of their political space in the mainstream politics - the constitution of Nepal has recognized Tharus to provide reservation for the political space.

Keywords: community museum, tharu, , identity, culture

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Authors: J. Szpor, K. Witczak, M. Storman, A. Orchel, D. Hodorowicz-Zaniewska, K. Okoń, A. Klimkowska

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Core needle biopsy (CNB) is well established as an important diagnostic tool in diagnosing breast cancer and it is now considered the initial method of choice for diagnosing breast disease. In comparison to fine needle aspiration (FNA), CNB provides more architectural information allowing for the evaluation of prognostic and predictive factors for breast cancer, including histological grade—one of three prognostic factors used to calculate the Nottingham Prognostic Index. Several studies have previously described the concordance rate between CNB and surgical excision specimen in determination of histological grade (HG). The concordance rate previously ascribed to overall grade varies widely across literature, ranging from 59-91%. The aim of this study is to see how the data looks like in material at authors’ institution and are the results as compared to those described in previous literature. The study population included 157 women with a breast tumor who underwent a core needle biopsy for breast carcinoma and a subsequent surgical excision of the tumor. Both materials were evaluated for the determination of histological grade (scale from 1 to 3). HG was assessed only in core needle biopsies containing at least 10 well preserved HPF with invasive tumor. The degree of concordance between CNB and surgical excision specimen for the determination of tumor grade was assessed by Cohen’s kappa coefficient. The level of agreement between core needle biopsy and surgical resection specimen for overall histologic grading was 73% (113 of 155 cases). CNB correctly predicted the grade of the surgical excision specimen in 21 cases for grade 1 tumors (Kappa coefficient κ = 0.525 95% CI (0.3634; 0.6818), 52 cases for grade 2 (Kappa coefficient κ = 0.5652 95% CI (0.458; 0.667) and 40 cases for stage 3 tumors (Kappa coefficient κ = 0.6154 95% CI (0.4862; 0.7309). The highest level of agreement was observed in grade 3 malignancies. In 9 of 42 (21%) discordant cases, the grade was higher in the CNB than in the surgical excision. This composed 6% of the overall discordance. These results correspond to the noted in the literature, showing that underestimation occurs more frequently than overestimation. This study shows that authors’ institution’s histologic grading of CNBs and surgical excisions shows a fairly good correlation and is consistent with findings in previous reports. Despite the inevitable limitations of CNB, CNB is an effective method for diagnosing breast cancer and managing treatment options. Assessment of tumour grade by CNB is useful for the planning of treatment, so in authors’ opinion it is worthy to implement it in daily practice.

Keywords: breast cancer, concordance, core needle biopsy, histological grade

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Authors: Yoseph Halala Handiso, Zewdi Gebregziabher

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Background: Malnutrition in hospitalized patients remains a major public health problem in both developed and developing countries. Despite the fact that malnourished patients are more prone to stay longer in hospital, there is limited data regarding the magnitude of malnutrition and its effect on length of stay among surgical patients in Ethiopia, while nutritional assessment is also often a neglected component of the health service practice. Objective: This study aimed to assess the prevalence of malnutrition at admission and its effect on the length of hospital stay among adult surgical patients in Wolaita Sodo University Comprehensive Specialized Hospital, South Ethiopia, 2022. Methods: A facility-based prospective cohort study was conducted among 398 adult surgical patients admitted to the hospital. Participants in the study were chosen using a convenient sampling technique. Subjective global assessment was used to determine the nutritional status of patients with a minimum stay of 24 hours within 48 hours after admission (SGA). Data were collected using the open data kit (ODK) version 2022.3.3 software, while Stata version 14.1 software was employed for statistical analysis. The Cox regression model was used to determine the effect of malnutrition on the length of hospital stay (LOS) after adjusting for several potential confounders taken at admission. Adjusted hazard ratio (HR) with a 95% confidence interval was used to show the effect of malnutrition. Results: The prevalence of hospital malnutrition at admission was 64.32% (95% CI: 59%-69%) according to the SGA classification. Adult surgical patients who were malnourished at admission had higher median LOS (12 days: 95% CI: 11-13) as compared to well-nourished patients (8 days: 95% CI: 8-9), means adult surgical patients who were malnourished at admission were at higher risk of reduced chance of discharge with improvement (prolonged LOS) (AHR: 0.37, 95% CI: 0.29-0.47) as compared to well-nourished patients. Presence of comorbidity (AHR: 0.68, 95% CI: 0.50-90), poly medication (AHR: 0.69, 95% CI: 0.55-0.86), and history of admission (AHR: 0.70, 95% CI: 0.55-0.87) within the previous five years were found to be the significant covariates of the length of hospital stay (LOS). Conclusion: The magnitude of hospital malnutrition at admission was found to be high. Malnourished patients at admission had a higher risk of prolonged length of hospital stay as compared to well-nourished patients. The presence of comorbidity, polymedication, and history of admission were found to be the significant covariates of LOS. All stakeholders should give attention to reducing the magnitude of malnutrition and its covariates to improve the burden of LOS.

Keywords: effect of malnutrition, length of hospital stay, surgical patients, Ethiopia

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Authors: Wayne Tarrant, Ethan Petersen

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The concept of a flat tax goes back to at least the Biblical tithe. A progressive income tax was first vociferously espoused in a small, but famous, pamphlet in 1848 (although England had an emergency progressive tax for war costs prior to this). Within a few years many countries had adopted the progressive structure. The flat tax was only reinstated in some small countries and British protectorates until Mart Laar was elected Prime Minister of Estonia in 1992. Since Estonia’s adoption of the flat tax in 1993, many other formerly Communist countries have likewise abandoned progressive income taxes. Economists had expectations of what would happen when a flat tax was enacted, but very little work has been done on actually measuring the effect. With a testbed of 21 countries in this region that currently have a flat tax, much comparison is possible. Several countries have retained progressive taxes, giving an opportunity for contrast. There are also the cases of Czech Republic and Slovakia, which have adopted and later abandoned the flat tax. Further, with over 20 years’ worth of economic history in some flat tax countries, we can begin to do some serious longitudinal study. In this paper we consider many economic variables to determine if there are statistically significant differences from before to after the adoption of a flat tax. We consider unemployment rates, tax receipts, GDP growth, Gini coefficients, and market data where the data are available. Comparisons are made through the use of event studies and time series methods. The results are mixed, but we draw statistically significant conclusions about some effects. We also look at the different implementations of the flat tax. In some countries there are equal income and corporate tax rates. In others the income tax has a lower rate, while in others the reverse is true. Each of these sends a clear message to individuals and corporations. The policy makers surely have a desired effect in mind. We group countries with similar policies, try to determine if the intended effect actually occurred, and then report the results. This is a work in progress, and we welcome the suggestion of variables to consider. Further, some of the data from before the fall of the Iron Curtain are suspect. Since there are new ruling regimes in these countries, the methods of computing different statistical measures has changed. Although we first look at the raw data as reported, we also attempt to account for these changes. We show which data seem to be fictional and suggest ways to infer the needed statistics from other data. These results are reported beside those on the reported data. Since there is debate about taxation structure, this paper can help inform policymakers of change the flat tax has caused in other countries. The work shows some strengths and weaknesses of a flat tax structure. Moreover, it provides beginnings of a scientific analysis of the flat tax in practice rather than having discussion based solely upon theory and conjecture.

Keywords: flat tax, financial markets, GDP, unemployment rate, Gini coefficient

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