Search results for: pregnancy outcomes
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3968

Search results for: pregnancy outcomes

2738 Early Metastatic Cancer: A Review of Its Management and Outcomes

Authors: Diwei Lin, Amanda Jia Hui Tan

Abstract:

In 2012, testicular cancer was estimated to account for 940 disability adjusted life years in Australia; of these, 450 were years lost due to premature death and 500 were years of healthy life lost due to disease, disability or injury. Testicular choriocarcinoma is one of the rarest variants of testicular germ cell tumours, accounting for less than 1% of testicular germ cell tumours and only about 0.19% of all testicular tumours. Management involves radical orchiectomy followed by chemotherapy. Even then, the prognosis is extremely poor. This case report describes a 20-year-old male with pure testicular choriocarcinoma with pulmonary metastases.

Keywords: testicular cancer, choriocarcinoma, cryptorchidism, chemotherapy, metastatic testicular cancer

Procedia PDF Downloads 363
2737 HKIE Accreditation: A Comparative Study on the Old and New Criteria

Authors: Peter P. K. Chiu

Abstract:

This paper reports a comparative study of new and old criteria for the professional accreditation of programme by the Hong Kong Institution of Engineers (HKIE). The major change in the criteria is the adoption of the outcome-based accreditation criteria and the use of measurement of attainment of outcomes which is very different from what academic did in the past. This has imposed a lot of difficulty for people in preparation for such exercise. Through this comparative study, the major difference between the two criteria is identified and a methodology is devised to help the academic to handle the issues due to the adoption of the new criteria. Thus it saves a lot of efforts.

Keywords: Hong Kong institution of engineers, outcome-based accreditation, Sydney accord, Washington accord

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2736 Psychical Impacts of Episiotomy: First Results

Authors: Clesse C., Lighezzolo-Alnot J., De Lavergne S.

Abstract:

Considered as the most common surgical procedure worldwide, episiotomy can be defined as an incision around the vulva performed to enlarge it, in the aim of preventing the traumatic rupture of the perineum during childbirth. Rather mediatized, this practice raises many questions in the field of mental health, relayed by different users and health professionals. Today, is topicality is moderately hectic since many queries about the prophylactic exercise of episiotomy are subject to a relative consensus, particularly since WHO advocated in 1996 that only 10% of childbirths should involve an episiotomy. This indicator appeared after the publication of numerous results from randomized clinical trials. Unfortunately, these papers seem mostly centered about somatic impacts of episiotomy. From the side of psychological studies, they mostly integrate a major clinical methodological bias, especially considering that every primiparous woman is identical to the others face to the experience of parturition. In the aim to fill this lack of knowledge, we developed a longitudinal research starting in the 7th month of pregnancy and ending one year after delivery. We are studying in a comparative way different possible psychological consequences inherent to the use of episiotomy. To do this, we use a standardized methodology which combines semi-structured clinical interviews (IRMAG, IRMAN ...), free clinical interviews, a projective test (Rorschach) and five questionnaires (QIC, EPDS, CPQ WOMBLSQ4, SF36). Therefore, we can comprehend with shrewdness the question of psychic impacts of episiotomy in a qualitative and quantitative way by comparing it to other obstetric interventions. In this paper, we will present the first results obtained about a population of twenty-two primiparous women by focusing on body image, sexuality, quality of life, depressive affects, post-traumatic stress disorder and investment of the maternal role. Finally, we will consider the different implications and perspectives of this research which could improve the public health policies in the field of perinatal care.

Keywords: assessment, episiotomy, mental health, psychical impacts

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2735 Using Integrative Assessment in Distance Learning: The Case of Department of Education - Navotas City

Authors: Meduranda Marco

Abstract:

This paper aimed to discuss the Integrative Assessment (IA) initiative of the Schools Division Office - Navotas City. The introduction provided a brief landscape analysis of the current state of education, the context of SDO Navotas, and the rationale for the administration of Integrative Assessment (IA) in schools. The IA methodology, procedure, and implementation activities were also shared. Feedback and reports on IA showed positive results as all schools in the Division were able to operationalize IA and consequently foster academic ease for learners and parents. Challenges met after compliance were also documented and strategies to continuously improve the Integrative Assessment process were proposed.

Keywords: distance learning assessment, integrative assessment, academic ease, learning outcomes evaluation

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2734 Association of Vulnerability and Behavioural Outcomes of FSWs Linked with TI Prevention HIV Program: An Evidence from Cross-Sectional Behavioural Study in Thane District of Maharashtra

Authors: Jayanta Bora, Sukhvinder Kaur, Ashok Agarwal, Sangeeta Kaul

Abstract:

Background: It is important for targeted interventions to consider vulnerabilities of female sex workers (FSWs) such as poverty, work-related mobility and literacy for effective human immunodeficiency virus (HIV) prevention. This paper examines the association between vulnerability and behavioural outcomes among FSWs in Thane district, Maharashtra under USAID PHFI-PIPPSE project. Methods: Data were used from the Behavioural Tracking Survey, a cross-sectional behavioural study conducted in 2015 with 503 FSWs randomly selected from 12 TI-NGOs which were functioning and providing services to FSWs in Thane district prior to April 2014 in Thane district of Maharashtra. We have created the “vulnerability index”, a composite index of literacy, factors of dependence (alternative livelihood options, current debt), and aspects of sex work (mobility and duration in sex work) as a dependent variable. The key independent measures used were program exposure to intervention, service uptake, self-confidence, and self-identity. Bi-variate and multivariate logistic regressions were used to examine the study objectives. Results: A higher proportion of FSWs who were in the age-group 18–25 years from brothel/street /home/ lodge-based were categorized as highly vulnerable to HIV risk as compared to bar-based sex worker (74.1% versus 59.8%, P,0.002); regression analysis highlighted lower odds of vulnerability among FSWs who were aware of services and visited NGO clinic for medical check-up and counselling for STI [AOR= 0.092, 95% CI 0.018-0.460; P,0.004], However, lower odds of vulnerability on confident in supporting fellow sex worker in crisis [AOR= 0.601, 95% CI 0.476-0.758; P, 0.000] and were able to turn away clients when they refused to use a condom during sex [AOR= 0.524, 95% CI 0.342-0.802; P, 0.003]. Conclusion: The results highlight that FSWs associated with TIs and getting services are less vulnerable and highly empowered. As a result of behavioural change communication and other services provided by TIs, FSWs were able to successfully negotiate about condom use with their clients and manage solidarity in the crisis situation for fellow FSWs. Therefore, it is evident from study paper that TI prevention programs may transform the lives of masses considerably and may open a window of opportunity to infuse the information and awareness about HIV risk.

Keywords: female sex worker, HIV prevention, HIV service uptake, vulnerability

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2733 Sustainability Impact Assessment of Construction Ecology to Engineering Systems and Climate Change

Authors: Moustafa Osman Mohammed

Abstract:

Construction industry, as one of the main contributor in depletion of natural resources, influences climate change. This paper discusses incremental and evolutionary development of the proposed models for optimization of a life-cycle analysis to explicit strategy for evaluation systems. The main categories are virtually irresistible for introducing uncertainties, uptake composite structure model (CSM) as environmental management systems (EMSs) in a practice science of evaluation small and medium-sized enterprises (SMEs). The model simplified complex systems to reflect nature systems’ input, output and outcomes mode influence “framework measures” and give a maximum likelihood estimation of how elements are simulated over the composite structure. The traditional knowledge of modeling is based on physical dynamic and static patterns regarding parameters influence environment. It unified methods to demonstrate how construction systems ecology interrelated from management prospective in procedure reflects the effect of the effects of engineering systems to ecology as ultimately unified technologies in extensive range beyond constructions impact so as, - energy systems. Sustainability broadens socioeconomic parameters to practice science that meets recovery performance, engineering reflects the generic control of protective systems. When the environmental model employed properly, management decision process in governments or corporations could address policy for accomplishment strategic plans precisely. The management and engineering limitation focuses on autocatalytic control as a close cellular system to naturally balance anthropogenic insertions or aggregation structure systems to pound equilibrium as steady stable conditions. Thereby, construction systems ecology incorporates engineering and management scheme, as a midpoint stage between biotic and abiotic components to predict constructions impact. The later outcomes’ theory of environmental obligation suggests either a procedures of method or technique that is achieved in sustainability impact of construction system ecology (SICSE), as a relative mitigation measure of deviation control, ultimately.

Keywords: sustainability, environmental impact assessment, environemtal management, construction ecology

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2732 Sustainability Framework for Water Management in New Zealand's Canterbury Region

Authors: Bryan Jenkins

Abstract:

Introduction: The expansion of irrigation in the Canterbury region has led to the sustainability limits being reached for water availability and the cumulative effects of land use intensification. The institutional framework under New Zealand’s Resource Management Act was found to be an inadequate basis for managing water at sustainability limits. An alternative paradigm for water management was developed based on collaborative governance and nested adaptive systems. This led to the formulation and implementation of the Canterbury Water Management Strategy. Methods: The nested adaptive system approach was adopted. Sustainability issues were identified at multiple spatial and time scales and defined potential failure pathways for the water resource system. These included biophysical and socio-economic issues such as water availability, cumulative effects on water quality due to land use intensification, projected changes in climate, public health, institutional arrangements, economic outcomes and externalities, and, social effects of changing technology. This led to the derivation of sustainability strategies to address these failure pathways. The collaborative governance approach involved stakeholder participation and community engagement to decide on a regional strategy; regional and zone committees of community and rūnanga (Māori groups) members to develop implementation programmes for the strategy; and, farmer collectives for operational management. Findings: The strategy identified improvements in the efficiency of use of water already allocated was more effective in improving water availability than a reliance on increased storage alone. New forms of storage with less adverse impacts were introduced, such as managed aquifer recharge and off-river storage. Reductions of nutrients from land use intensification by improving management practices has been a priority. Solutions packages for addressing the degradation of vulnerable lakes and rivers have been prepared. Biodiversity enhancement projects have been initiated. Greater involvement of Māori has led to the incorporation of kaitiakitanga (resource stewardship) into implementation programmes. Emerging issues are the need for improved integration of surface water and groundwater interactions, increased use of modelling of water and financial outcomes to guide decision making, and, equity in allocation among existing users as well as between existing and future users. Conclusions: However, sustainability analysis indicates that the proposed levels of management interventions are not sufficient to achieve community targets for water management. There is a need for more proactive recovery and rehabilitation measures. Managing to environmental limits is not sufficient, rather managing adaptive cycles is needed. Better measurement and management of water use efficiency is required. Proposed implementation packages are not sufficient to deliver desired water quality outcomes. Greater attention to targets important to environmental and recreational interests is needed to maintain trust in the collaborative process. Implementation programmes don’t adequately address climate change adaptations and greenhouse gas mitigation. Affordability is a constraint on adaptive capacity of farmers and communities. More funding mechanisms are required to implement proactive measures. The legislative and institutional framework needs to be changed to incorporate water framework legislation, regional sustainability strategies and water infrastructure coordination.

Keywords: collaborative governance, irrigation management, nested adaptive systems, sustainable water management

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2731 Effect of Distance to Health Facilities on Maternal Service Use and Neonatal Mortality in Ethiopia

Authors: Getiye Dejenu Kibret, Daniel Demant, Andrew Hayen

Abstract:

Introduction: In Ethiopia, more than half of newborn babies do not have access to Emergency Obstetric and Neonatal Care (EmONC) services. Understanding the effect of distance to health facilities on service use and neonatal survival is crucial to recommend policymakers and improve resource distribution. We aimed to investigate the effect of distance to health services on maternal service use and neonatal mortality. Methods: We implemented a data linkage method based on geographic coordinates and calculated straight-line (Euclidean) distances from the Ethiopian 2016 demographic and health survey clusters to the closest health facility. We computed the distance in ESRI ArcGIS Version 10.3 using the geographic coordinates of DHS clusters and health facilities. Generalised Structural Equation Modelling (GSEM) was used to estimate the effect of distance on neonatal mortality. Results: Poor geographic accessibility to health facilities affects maternal service usage and increases the risk of newborn mortality. For every ten kilometres (km) increase in distance to a health facility, the odds of neonatal mortality increased by 1.33% (95% CI: 1.06% to 1.67%). Distance also negatively affected antenatal care, facility delivery and postnatal counselling service use. Conclusions: A lack of geographical access to health facilities decreases the likelihood of newborns surviving their first month of life and affects health services use during pregnancy and immediately after birth. The study also showed that antenatal care use was positively associated with facility delivery service use and that both positively influenced postnatal care use, demonstrating the interconnectedness of the continuum of care for maternal and neonatal care services. Policymakers can leverage the findings from this study to improve accessibility barriers to health services.

Keywords: acessibility, distance, maternal health service, neonatal mortality

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2730 The Impact of Entrepreneurship Education on the Entrepreneurial Tendencies of Students: A Quasi-Experimental Design

Authors: Lamia Emam

Abstract:

The attractiveness of entrepreneurship education stems from its perceived value as a venue through which students can develop an entrepreneurial mindset, skill set, and practice, which may not necessarily lead to them starting a new business, but could, more importantly, be manifested as a life skill that could be applied to all types of organizations and career endeavors. This, in turn, raises important questions about what happens in our classrooms; our role as educators, the role of students, center of learning, and the instructional approach; all of which eventually contribute to achieving the desired EE outcomes. With application to an undergraduate entrepreneurship course -Entrepreneurship as Practice- the current paper aims to explore the effect of entrepreneurship education on the development of students’ general entrepreneurial tendencies. Towards that purpose, the researcher herein uses a pre-test and post-test quasi-experimental research design where the Durham University General Enterprising Tendency Test (GET2) is administered to the same group of students before and after course delivery. As designed and delivered, the Entrepreneurship as Practice module is a highly applied and experiential course where students are required to develop an idea for a start-up while practicing the entrepreneurship-related knowledge, mindset, and skills that are taught in class, both individually and in groups. The course is delivered using a combination of short lectures, readings, group discussions, case analysis, guest speakers, and, more importantly, actively engaging in a series of activities that are inspired by diverse methods for developing successful and innovative business ideas, including design thinking, lean-start up and business feasibility analysis. The instructional approach of the course particularly aims at developing the students' critical thinking, reflective, analytical, and creativity-based problem-solving skills that are needed to launch one’s own start-up. The analysis and interpretation of the experiment’s outcomes shall simultaneously incorporate the views of both the educator and students. As presented, the study responds to the rising call for the application of experimental designs in entrepreneurship in general and EE in particular. While doing so, the paper presents an educator’s perspective of EE to complement the dominant stream of research which is constrained to the students’ point of view. Finally, the study sheds light on EE in the MENA region, where the study is applied.

Keywords: entrepreneurship education, andragogy and heutagogy, scholarship of teaching and learning, experiment

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2729 Self-Efficacy Psychoeducational Programme for Patients With End-Stage Renal Disease

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

Abstract:

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

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

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2728 Considerations for the Use of High Intensity Interval Training in Secondary Physical Education

Authors: Amy Stringer, Resa Chandler

Abstract:

High Intensity Interval Training (HIIT) involves a 3-10-minute circuit of various exercises which is a viable alternative to a traditional cardiovascular and strength training regimen. Research suggests that measures of health-related fitness can either be maintained or actually improve with the use of this training method. After conducting a 6-week HIIT research study with 10-14 year old children, considerations for using a daily HIIT workout are presented. Is the use of HIIT with children a reasonable consideration for physical education programs? The benefits and challenges of this type of an intervention are identified. This study is significant in that achieving fitness gains in a small amount of daily class time is an attractive concept – especially for physical education teachers who often do not have the time necessary to accomplish all of their curricular goals in the amount of class time assigned. Basic methodologies include students participating in a circuit of exercises for 7-10 minutes at 80-95% of max heart rate as measured by heart rate monitors. Student pre and post fitness test data were collected for cardio-vascular endurance, muscular endurance, and body composition. Research notes as well as commentary by the teachers and researchers who participated in the HIIT study contributed to the understanding of the cost-benefit analysis. Major findings of the study are that HIIT has limited effectiveness but is a good choice for limited class times. Student efficacy of their ability to complete the exercises and visible heart rate data were considered to be significant factors in success of the HIIT study. The effective use of technology promoting positive audience effect during the display of heart rate data was more important at the beginning of the study than at the end. Student ‘buy-in’ and motivation, teacher motivation and ‘buy-in’, the variety of activities in the circuit and the fitness level of the student at the beginning of the study were also findings influencing the fitness outcomes of the study. Concluding Statement: High intensity interval training can be used effectively in a secondary physical education program. It is not a ‘magic bullet’ to produce health-related fitness outcomes in every student but it is an effective tool to enhance student fitness in a limited time and contribute to the goals of the program.

Keywords: cardio vascular fitness, children, high intensity interval training, physical education

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2727 Evaluating the Characteristics of Paediatric Accidental Poisonings

Authors: Grace Fangmin Tan, Elaine Yiling Tay, Elizabeth Huiwen Tham, Andrea Wei Ching Yeo

Abstract:

Background: While accidental poisonings in children may seem unavoidable, knowledge of circumstances surrounding such incidents and identification of risk factors is important in the development of secondary prevention strategies. Some risk factors include age of the child, lack of adequate supervision and improper storage of substances. The aim of this study is to assess risk factors and circumstances influencing outcomes in these children. Methodology: A retrospective medical record review of all accidental poisoning cases presenting to the Children’s Emergency at National University Hospital (NUH), Singapore between January 2014 and December 2015 was conducted. Information on demographics, poisoning circumstances and clinical outcomes were collected. Results: Ninety-nine of a total of 186 poisoning cases were accidental ingestions, with a mean age of 4.7 (range 0.4 to 18.3 years). The gender distribution is rather equal with 52(52.5%) females and 47(47.5%) males. Seventy-nine (79.8%) were self-administered by the child and in 20 cases (20.2%), the substance was administered erroneously by caregivers 12/20 (60.0%) of whom were given the wrong drug dose while 8/20 (40.0%) were given the wrong substance. Self-administration was associated with presentation to the ED within 12 hours (p=0.027, OR 6.65, 95% CI 1.24-35.72). Notably, 94.9% of the cases involved substances kept within reach of the child. Sixty-nine (82.1%) had the substance kept in the original container, 3(3.6%) in food containers, 8(9.5%) in other containers and 4(4.8%) without a container. Of the 50 cases with information on labelling, 40/50(80.0%) were accurately labelled, 2/50 (4.0%) wrongly labelled, and 8/50 (16.0%) were unlabelled. Implicated substances included personal care products (11.1%), household cleaning products (3.0%), and different classes of drugs such as paracetamol (22.2%), antihistamines (17.2%) and sympathomimetics (8.1%). Children < 3 years of age were 4.8 times more likely to be poisoned by household substances than children >3 years of age (p=0.009, 95% CI 1.48-15.77). Prehospital interventions were more likely to have been done in poisoning with household substances (p=0.005, OR 6.12 95% CI 1.73-21.68). Fifty-nine (59.6%) were asymptomatic, 34 (34.3%) had a Poisoning Severity Score (PSS) grade of 1 (minor) and 6 (6.1%) grade 2 (moderate). Older children were 9.3 times more likely to be symptomatic (p<0.001, 95% CI 3.15-27.25). Thirty (32%) required admission. Conclusion: A significant proportion of accidental poisoning cases were due to medication administration errors by caregivers, which should be preventable. Risk factors for accidental poisoning included lack of adequate caregiver supervision, improper labelling and young age of the child. There is an urgent need to improve caregiver counselling during medication dispensing as well as to educate caregivers on basic child safety measures in the home to prevent future accidental poisonings.

Keywords: accidental, caregiver, paediatrics, poisoning

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2726 Medical Complications in Diabetic Recipients after Kidney Transplantation

Authors: Hakan Duger, Alparslan Ersoy, Canan Ersoy

Abstract:

Diabetes mellitus is the most common etiology of end-stage renal disease (ESRD). Also, diabetic nephropathy is the etiology of ESRD in approximately 23% of kidney transplant recipients. A successful kidney transplant improves the quality of life and reduces the mortality risk for most patients. However, patients require close follow-up after transplantation due to medical complications. Diabetes mellitus can affect patient morbidity and mortality due to possible effects of immunosuppressive therapy on glucose metabolism. We compared the frequency of medical complications and the outcomes in diabetic and non-diabetic kidney transplant recipients. Materials and Methods: This retrospective study conducted in 498 patients who underwent kidney transplant surgery at our center in 10-year periods. The patients were divided into two groups: diabetics (46 ± 10 year, 26 males, 16 females) and non-diabetics (39 ± 12 year, 259 males, 197 females). The medical complications, graft functions, causes of graft loss and death were obtained from medical records. Results: There was no significant difference between recipient age, duration of dialysis, body mass index, gender, donor type, donor age, dialysis type, histories of HBV, HCV and coronary artery disease between two groups. The history of hypertension in diabetics was higher (69% vs. 36%, p < 0.001). The ratios of hypertension (50.1% vs. 57.1%), pneumonia (21.9% vs. 20%), urinary infection (16.9% vs. 20%), transaminase elevation (11.5% vs. 20%), hyperpotasemia (14.7% vs. 17.1%), hyponatremia (9.7% vs. 20%), hypotension (7.1% vs. 7.9%), hypocalcemia (1.4% vs. 0%), thrombocytopenia (8.6% vs. 8.6%), hypoglycemia (0.7% vs. 0%) and neutropenia (1.8% vs. 0%) were comparable in non-diabetic and diabetic groups, respectively. The frequency of hyperglycaemia in diabetics was higher (8.6% vs. 54.3%, p < 0.001). After transplantation, primary non-function (3.4% vs. 2.6%), delayed graft function (25.1% vs. 34.2%) and acute rejection (7.3% vs. 10.5%) ratios of in non-diabetic and diabetic groups were similar, respectively. Hospitalization durations in non-diabetics and diabetics were 22.5 ± 17.5 and 18.7 ± 13 day (p=0.094). Mean serum creatinine levels in non-diabetics and diabetics were 1.54 ± 0.74 and 1.52 ± 0.62 mg/dL at 6th month. Forty patients had graft loss. The ratios of graft loss and death in non-diabetic and diabetic groups were 8.2% vs. 7.1% and 7.1% vs. 2.6% (p > 0.05). There was no significant relationship between graft and patient survivals with the development of medical complication. Conclusion: As a result, medical complications are common in the early period. Hyperglycaemia was frequently seen following transplantation due to the effects of immunosuppressant regimens. However, the frequency of other medical complications in diabetic patients did not differ from non-diabetic one. The most important cause of death is still infections. The development of medical complications during the first 6 months did not significantly affect transplant outcomes.

Keywords: kidney transplantation, diabetes mellitus, complication, graft function

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2725 The Impact of Non-Surgical and Non-Medical Interventions on the Treatment of Infertile Women with Ovarian Reserve Below One and Early Menopause Symptoms

Authors: Flora Tajiki

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This study investigates the effectiveness of non-surgical and non-medical interventions in treating infertile women with severely diminished ovarian reserve (below one), low Anti-Müllerian Hormone (AMH) levels, and symptoms of early menopause. The intervention included yoga, sunlight exposure, vitamin and mineral supplementation, relaxation techniques, and daily prayers performed both before sleep and upon waking. These methods were applied to women who had shown poor response to high-dose fertility treatments, such as IVF and microinjection cycles, leading to low-quality egg production. The focus was on women with severely reduced ovarian reserve and early menopause symptoms, some of whom continued to experience relatively regular menstrual cycles despite the onset of these symptoms. This treatment was aimed at women for whom conventional fertility methods had been ineffective. The study sample consisted of 120 married women, aged 25 to 45, from the provinces of Tehran, Alborz, and western Iran, with 35 participants completing the intervention. Individual factors such as residence, education, employment status, marriage duration, family infertility history, and previous infertility treatments were examined, with income considered as a contextual variable. The results indicate that AMH may not be a definitive marker of ovarian reserve, as lifestyle modifications, such as those implemented in this study, were associated with increased AMH levels, the return of regular menstrual cycles, and successful pregnancies. No short- or long-term complications were reported during the two-year follow-up, highlighting the potential benefits of non-surgical interventions for women with early menopause symptoms and diminished ovarian reserve.

Keywords: anti-müllerian hormone, infertility, ovarian reserve, early menopause, fertility, women’s health, lifestyle modification, pregnancy

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2724 A Challenge of the 3ʳᵈ Millenium: The Emotional Intelligence Development

Authors: Florentina Hahaianu, Mihaela Negrescu

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The analysis of the positive and negative effects of technology use and abuse in Generation Z comes as a necessity in order to understand their ever-changing emotional development needs. The article quantitatively analyzes the findings of a sociological questionnaire on a group of students in social sciences. It aimed to identify the changes generated by the use of digital resources in the emotional intelligence development. Among the outcomes of our study we include a predilection for IT related activities – be they social, learning, entertainment, etc. which undermines the manifestation of emotional intelligence, especially the reluctance to face-to-face interaction. In this context, the issue of emotional intelligence development comes into focus as a solution to compensate for the undesirable effects that contact with technology has on this generation.

Keywords: digital resources, emotional intelligence, generation Z, students

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2723 Nanoliposomes in Photothermal Therapy: Advancements and Applications

Authors: Mehrnaz Mostafavi

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Nanoliposomes, minute lipid-based vesicles at the nano-scale, show promise in the realm of photothermal therapy (PTT). This study presents an extensive overview of nanoliposomes in PTT, exploring their distinct attributes and the significant progress in this therapeutic methodology. The research delves into the fundamental traits of nanoliposomes, emphasizing their adaptability, compatibility with biological systems, and their capacity to encapsulate diverse therapeutic substances. Specifically, it examines the integration of light-absorbing materials, like gold nanoparticles or organic dyes, into nanoliposomal formulations, enabling their efficacy as proficient agents for photothermal treatment Additionally, this paper elucidates the mechanisms involved in nanoliposome-mediated PTT, highlighting their capability to convert light energy into localized heat, facilitating the precise targeting of diseased cells or tissues. This precise regulation of light absorption and heat generation by nanoliposomes presents a non-invasive and precisely focused therapeutic approach, particularly in conditions like cancer. The study explores advancements in nanoliposomal formulations aimed at optimizing PTT outcomes. These advancements include strategies for improved stability, enhanced drug loading, and the targeted delivery of therapeutic agents to specific cells or tissues. Furthermore, the paper discusses multifunctional nanoliposomal systems, integrating imaging components or targeting elements for real-time monitoring and improved accuracy in PTT. Moreover, the review highlights recent preclinical and clinical trials showcasing the effectiveness and safety of nanoliposome-based PTT across various disease models. It also addresses challenges in clinical implementation, such as scalability, regulatory considerations, and long-term safety assessments. In conclusion, this paper underscores the substantial potential of nanoliposomes in advancing PTT as a promising therapeutic approach. Their distinctive characteristics, combined with their precise ability to convert light into heat, offer a tailored and efficient method for treating targeted diseases. The encouraging outcomes from preclinical studies pave the way for further exploration and potential clinical applications of nanoliposome-based PTT.

Keywords: nanoliposomes, photothermal therapy, light absorption, heat conversion, therapeutic agents, targeted delivery, cancer therapy

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2722 Follower Upward Influence Tactics: A Review of Quantitative Studies

Authors: Najla Alshenaifi, Nicholas Clarke

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Interest in how followers may influence their leaders in order to achieve their goals can be traced to studies in the late 1970s. The last major review of the literature was published over a decade ago in 2002. It would seem timely then to take stock of the literature and consider what we have learned since then. In so doing, our aim is to derive an empirically-based framework for understanding the effects of upward influence tactics to underpin future research in the field. Many factors are identified as having a major effect on upward influence processes including goals of influence, culture, gender, leadership style and the outcome of influence. A key conclusion from our review is that although upward influence tactics can result in positive outcomes for followers, the results from many studies are more often than inconclusive.

Keywords: upward influence tactics, influence tactics, influence strategies, followership

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2721 Artificial Intelligence for All: Artificial Intelligence Education for K-12

Authors: Yiqiao Yin

Abstract:

Many scholars and educators have dedicated their lives in K12 education system and there has been an exploding amount of attention to implement technical foundations for Artificial Intelligence Education for high school and precollege level students. This paper focuses on the development and use of resources to support K-12 education in Artificial Intelligence (AI). The author and his team have more than three years of experience coaching students from pre-college level age from 15 to 18. This paper is a culmination of the experience and proposed online tools, software demos, and structured activities for high school students. The paper also addresses a portfolio of AI concepts as well as the expected learning outcomes. All resources are provided with online videos and Github repositories for immediate use.

Keywords: K12 education, AI4ALL, pre-college education, pre-college AI

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2720 Efficacy and Safety of Updated Target Therapies for Treatment of Platinum-Resistant Recurrent Ovarian Cancer

Authors: John Hang Leung, Shyh-Yau Wang, Hei-Tung Yip, Fion, Ho Tsung-chin, Agnes LF Chan

Abstract:

Objectives: Platinum-resistant ovarian cancer has a short overall survival of 9–12 months and limited treatment options. The combination of immunotherapy and targeted therapy appears to be a promising treatment option for patients with ovarian cancer, particularly to patients with platinum-resistant recurrent ovarian cancer (PRrOC). However, there are no direct head-to-head clinical trials comparing their efficacy and toxicity. We, therefore, used a network to directly and indirectly compare seven newer immunotherapies or targeted therapies combined with chemotherapy in platinum-resistant relapsed ovarian cancer, including antibody-drug conjugates, PD-1 (Programmed death-1) and PD-L1 (Programmed death-ligand 1), PARP (Poly ADP-ribose polymerase) inhibitors, TKIs (Tyrosine kinase inhibitors), and antiangiogenic agents. Methods: We searched PubMed (Public/Publisher MEDLINE), EMBASE (Excerpta Medica Database), and the Cochrane Library electronic databases for phase II and III trials involving PRrOC patients treated with immunotherapy or targeted therapy plus chemotherapy. The quality of included trials was assessed using the GRADE method. The primary outcomes compared were progression-free survival, the secondary outcomes were overall survival and safety. Results: Seven randomized controlled trials involving a total of 2058 PRrOC patients were included in this analysis. Bevacizumab plus chemotherapy showed statistically significant differences in PFS (Progression-free survival) but not OS (Overall survival) for all interested targets and immunotherapy regimens; however, according to the heatmap analysis, bevacizumab plus chemotherapy had a statistically significant risk of ≥grade 3 SAEs (Severe adverse effects), particularly hematological severe adverse events (neutropenia, anemia, leukopenia, and thrombocytopenia). Conclusions: Bevacizumab plus chemotherapy resulted in better PFS as compared with all interested regimens for the treatment of PRrOC. However, statistical differences in SAEs as bevacizumab plus chemotherapy is associated with a greater risk for hematological SAE.

Keywords: platinum-resistant recurrent ovarian cancer, network meta-analysis, immune checkpoint inhibitors, target therapy, antiangiogenic agents

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2719 Ethical Considerations in In-Utero Gene Editing

Authors: Shruti Govindarajan

Abstract:

In-utero gene editing with CRISPR-Cas9 opens up new possibilities for treating genetic disorders during pregnancy while still in mother’s womb. By targeting genetic mutations in the early stages of fetal development, this approach could potentially prevent severe conditions—like cystic fibrosis, sickle cell anemia, and muscular dystrophy—from causing harm. CRISPR-Cas9, which allows precise DNA edits, could be delivered into fetal cells through vectors such as adeno-associated viruses (AAVs) or nanoparticles, correcting disease-causing mutations and possibly offering lifelong relief from these disorders. For families facing severe genetic diagnoses, in-utero gene editing could provide a transformative option. However, technical challenges remain, including ensuring that gene editing only targets the intended cells and verifying long-term safety. Ethical considerations are also at the forefront of this technology. The editing of a fetus's genes brings up difficult questions about consent, especially since these genetic changes will affect the child’s entire life without their input. There's also concern over possible unintended side effects, or changes passed down to future generations. Moreover, if used beyond therapeutic purposes, this technology could be misused for ‘enhancements,’ like selecting for certain physical or cognitive traits, raising concerns about inequality and social pressures. In this way, in-utero gene editing brings both exciting potential and complex moral questions. As research progresses, addressing these scientific and ethical concerns will be key to ensuring that this technology is used responsibly, prioritizing safety, fairness, and a focus on alleviating genetic disease. A cautious and inclusive approach, along with clear regulations, will be essential to realizing the benefits of in-utero gene editing while protecting against unintended consequences.

Keywords: in-utero gene editing, CRISPR, bioethics, genetic disorder

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2718 Effects of Foreign-language Learning on Bilinguals' Production in Both Their Languages

Authors: Natalia Kartushina

Abstract:

Foreign (second) language (L2) learning is highly promoted in modern society. Students are encouraged to study abroad (SA) to achieve the most effective learning outcomes. However, L2 learning has side effects for native language (L1) production, as L1 sounds might show a drift from the L1 norms towards those of the L2, and this, even after a short period of L2 learning. L1 assimilatory drift has been attributed to a strong perceptual association between similar L1 and L2 sounds in the mind of L2 leaners; thus, a change in the production of an L2 target leads to the change in the production of the related L1 sound. However, nowadays, it is quite common that speakers acquire two languages from birth, as, for example, it is the case for many bilingual communities (e.g., Basque and Spanish in the Basque Country). Yet, it remains to be established how FL learning affects native production in individuals who have two native languages, i.e., in simultaneous or very early bilinguals. Does FL learning (here a third language, L3) affect bilinguals’ both languages or only one? What factors determine which of the bilinguals’ languages is more susceptible to change? The current study examines the effects of L3 (English) learning on the production of vowels in the two native languages of simultaneous Spanish-Basque bilingual adolescents enrolled into the Erasmus SA English program. Ten bilingual speakers read five Spanish and Basque consonant-vowel-consonant-vowel words two months before their SA and the next day after their arrival back to Spain. Each word contained the target vowel in the stressed syllable and was repeated five times. Acoustic analyses measuring vowel openness (F1) and backness (F2) were performed. Two possible outcomes were considered. First, we predicted that L3 learning would affect the production of only one language and this would be the language that would be used the most in contact with English during the SA period. This prediction stems from the results of recent studies showing that early bilinguals have separate phonological systems for each of their languages; and that late FL learner (as it is the case of our participants), who tend to use their L1 in language-mixing contexts, have more L2-accented L1 speech. The second possibility stated that L3 learning would affect both of the bilinguals’ languages in line with the studies showing that bilinguals’ L1 and L2 phonologies interact and constantly co-influence each other. The results revealed that speakers who used both languages equally often (balanced users) showed an F1 drift in both languages toward the F1 of the English vowel space. Unbalanced speakers, however, showed a drift only in the less used language. The results are discussed in light of recent studies suggesting that the amount of language use is a strong predictor of the authenticity in speech production with less language use leading to more foreign-accented speech and, eventually, to language attrition.

Keywords: language-contact, multilingualism, phonetic drift, bilinguals' production

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2717 The Europeanization of Minority and Disability Rights: A Comparative View

Authors: Katharina Crepaz

Abstract:

Both minority rights and disability rights are relatively new fields for policy-making in a European context, and both are affected by the EU’s diversity mainstreaming approach, as well as by the non-discrimination legislation drafted at the European level. These processes correspond to the classic understanding of Europeanization, namely a “top-down” stream of influence from the European to the national and subnational levels. However, both minority and disability rights movements also show instances of “bottom-up” Europeanization, e.g. transnational advocacy networks and efforts to reach joint goals at the EU-level. This paper aims to provide a comparative perspective on Europeanization in both fields, pointing out similar dynamics and patterns, but also explaining in which sectors outcomes may be different and which domestic and other scope conditions may be responsible for these differences.

Keywords: europeanization, disability rights, minority rights, comparative perspective

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2716 Engineering Topology of Ecological Model for Orientation Impact of Sustainability Urban Environments: The Spatial-Economic Modeling

Authors: Moustafa Osman Mohammed

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The modeling of a spatial-economic database is crucial in recitation economic network structure to social development. Sustainability within the spatial-economic model gives attention to green businesses to comply with Earth’s Systems. The natural exchange patterns of ecosystems have consistent and periodic cycles to preserve energy and materials flow in systems ecology. When network topology influences formal and informal communication to function in systems ecology, ecosystems are postulated to valence the basic level of spatial sustainable outcome (i.e., project compatibility success). These referred instrumentalities impact various aspects of the second level of spatial sustainable outcomes (i.e., participant social security satisfaction). The sustainability outcomes are modeling composite structure based on a network analysis model to calculate the prosperity of panel databases for efficiency value, from 2005 to 2025. The database is modeling spatial structure to represent state-of-the-art value-orientation impact and corresponding complexity of sustainability issues (e.g., build a consistent database necessary to approach spatial structure; construct the spatial-economic-ecological model; develop a set of sustainability indicators associated with the model; allow quantification of social, economic and environmental impact; use the value-orientation as a set of important sustainability policy measures), and demonstrate spatial structure reliability. The structure of spatial-ecological model is established for management schemes from the perspective pollutants of multiple sources through the input–output criteria. These criteria evaluate the spillover effect to conduct Monte Carlo simulations and sensitivity analysis in a unique spatial structure. The balance within “equilibrium patterns,” such as collective biosphere features, has a composite index of many distributed feedback flows. The following have a dynamic structure related to physical and chemical properties for gradual prolong to incremental patterns. While these spatial structures argue from ecological modeling of resource savings, static loads are not decisive from an artistic/architectural perspective. The model attempts to unify analytic and analogical spatial structure for the development of urban environments in a relational database setting, using optimization software to integrate spatial structure where the process is based on the engineering topology of systems ecology.

Keywords: ecological modeling, spatial structure, orientation impact, composite index, industrial ecology

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2715 Fabrication of a Potential Point-of-Care Device for Hemoglobin A1c: A Lateral Flow Immunosensor

Authors: Shu Hwang Ang, Choo Yee Yu, Geik Yong Ang, Yean Yean Chan, Yatimah Binti Alias, And Sook Mei Khor

Abstract:

With the high prevalence of Type 2 diabetes mellitus across the world, the morbidities and mortalities associated with Type 2 diabetes have significant impact on the production line for a nation. With routine scheduled clinical visits to manage Type 2 diabetes, diabetic patients with hectic lifestyles can have low clinical compliance. Hence, it often decreases the effectiveness of diabetic management personalized for each diabetic patient. Here, we report a useful developed point-of-care (POC) device that detect glycated hemoglobin (HbA1c, biomarker for long-term Type 2 diabetic management). In fact, the established POC devices certified to be used in clinical setting are not only expensive ($ 8 to $10 per test), they also require skillful practitioners to perform sampling and interpretation. As a paper-based biosensor, the developed HbA1c biosensor utilized lateral flow principle to offer an alternative for cost-effective (approximately $2 per test) and end-user friendly device for household testing. Requiring as little as 2 L of finger-picked blood, the test can be performed at the household with just simple dilution and washings. With visual interpretation of numbers of test lines shown on the developed biosensor, it can be interpreted as easy as a urine pregnancy test, aided with scale of intensity provided. In summary, the developed HbA1c immunosensor has been tested to have high selectivity towards HbA1c, and is stable with reasonably good performance in clinical testing. Therefore, our developed HbA1c immunosensor has high potential to be an effective diabetic management tool to increase patient compliance and thus contain the progression of the diabetes.

Keywords: blood, glycated hemoglobin (HbA1c), lateral flow, type 2 diabetes mellitus

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2714 Effect of Cognitive Rehabilitation in Pediatric Population with Acquired Brain Injury: A Pilot Study

Authors: Carolina Beltran, Carlos De Los Reyes

Abstract:

Acquired brain injury (ABI) is any physical and functional injury secondary to events that affect the brain tissue. It is one of the biggest causes of disability in the world and it has a high annual incidence in the pediatric population. There are several causes of ABI such as traumatic brain injury, central nervous system infection, stroke, hypoxia, tumors and others. The consequences can be cognitive, behavioral, emotional and functional. The cognitive rehabilitation is necessary to achieve the best outcomes for pediatric people with ABI. Cognitive orientation to daily occupational performance (CO-OP) is an individualized client-centered, performance-based, problem-solving approach that focuses on the strategy used to support the acquisition of three client-chosen goals. It has demonstrated improvements in the pediatric population with other neurological disorder but not in Spanish speakers with ABI. Aim: The main objective of this study was to determine the efficacy of cognitive orientation to daily occupational performances (CO-OP) adapted to Spanish speakers, in the level of independence and behavior in a pediatric population with ABI. Methods: Case studies with measure pre/post-treatment were used in three children with ABI, sustained at least before 6 months assessment, in school, aged 8 to 16 years, age ABI after 6 years old and above average intellectual ability. Twelve sessions of CO-OP adapted to Spanish speakers were used and videotaped. The outcomes were based on cognitive, behavior and functional independence measurements such as Child Behavior Checklist (CBCL), Behavior Rating Inventory of Executive Function (BRIEF), The Vineland Adaptive Behavior Scales (VINELAND, Social Support Scale (MOS-SSS) and others neuropsychological measures. This study was approved by the ethics committee of Universidad del Norte in Colombia. Informed parental written consent was obtained for all participants. Results: children were able to identify three goals and use the global strategy ‘goal-plan-do-check’ during each session. Verbal self-instruction was used by all children. CO-OP showed a clinically significant improvement in goals regarding with independence level and behavior according to parents and teachers. Conclusion: The results indicated that CO-OP and the use of a global strategy such as ‘goal-plan-do-check’ can be used in children with ABI in order to improve their specific goals. This is a preliminary version of a big study carrying in Colombia as part of the experimental design.

Keywords: cognitive rehabilitation, acquired brain injury, pediatric population, cognitive orientation to daily occupational performance

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2713 Education of Mothers and Influence on the Development of Intrauterine Growth Restriction

Authors: Sabina Garayeva

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To determine the significant risk factors for intrauterine growth restriction (IUGR), we carried out a thorough study of the social status of the parents of children with IUGR. We observed 315 mothers who gave birth to children with (IUGR), of which 172 mothers with asymmetric type and 143 mothers with symmetric type of IUGR. Through a detailed survey was gathered detailed information about education of parents. The results show that the majority of mothers with IUGR had secondary education (44,8 ± 2,8%), and fathers - higher education (35,2 ± 2,7%). Whereas in the control group, the largest number of parents had higher education (mother 35,3 ± 4,4%, fathers 42,9 ± 4,5%). Number of mothers with secondary education with IUGR was significantly (p1 <0,01; χ2 = 22,67) differs from the number of mothers with physiological pregnancy with the same level of education. Meanwhile, in the group with a symmetrical embodiment of IUGR mothers with secondary formation of significantly greater 53,1 ± 4,2%, than the asymmetric embodiment IUGR 37,8 ± 3,7% (p2 <0,05; χ2 = 8 06). Among fathers with secondary education significant difference was noted in the symmetric version of IUGR 37,8 ± 4,1% more than in the control group (p1 <0,05), and among parents of children with asymmetric IUGR option prevailed fathers with higher education - 37 2 ± 3,7%. Thus, our results revealed a low educational level of the mother as a risk factor for IUGR, which further help to develop preventive and therapeutic measures to eliminate the severity of its consequences. As seen from the data presented, mothers of children with asymmetric IUGR had a school education and fathers - higher education, while in the symmetric type of both parents had secondary education. It is found that frequency of children, born with IUGR, of mothers - housewives and fathers, engage in physical labor, was high. Thus, the analysis conducted by the social status of the parents with IUGR revealed a low level of education and unemployed mothers as risk factors for this disease, which in the future will help to develop preventive and therapeutic measures to eliminate the severity of its.

Keywords: intrauterine growth restriction, education of mothers, education influence, IUGR

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2712 Internal Mercury Exposure Levels Correlated to DNA Methylation of Imprinting Gene H19 in Human Sperm of Reproductive-Aged Man

Authors: Zhaoxu Lu, Yufeng Ma, Linying Gao, Li Wang, Mei Qiang

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Mercury (Hg) is a well-recognized environmental pollutant known by its toxicity of development and neurotoxicity, which may result in adverse health outcomes. However, the mechanisms underlying the teratogenic effects of Hg are not well understood. Imprinting genes are emerging regulators for fetal development subject to environmental pollutants impacts. In this study, we examined the association between paternal preconception Hg exposures and the alteration of DNA methylation of imprinting genes in human sperm DNA. A total of 618 men aged from 22 to 59 was recruited from the Reproductive Medicine Clinic of Maternal and Child Care Service Center and the Urologic Surgery Clinic of Shanxi Academy of Medical Sciences during April 2015 and March 2016. Demographic information was collected using questionnaires. Urinary Hg concentrations were measured using a fully-automatic double-channel hydride generation atomic fluorescence spectrometer. And methylation status in the DMRs of imprinting genes H19, Meg3 and Peg3 of sperm DNA were examined by bisulfite pyrosequencing in 243 participants. Spearman’s rank and multivariate regression analysis were used for correlation analysis between sperm DNA methylation status of imprinting genes and urinary Hg levels. The median concentration of Hg for participants overall was 9.09μg/l (IQR: 5.54 - 12.52μg/l; range = 0 - 71.35μg/l); no significant difference was found in median concentrations of Hg among various demographic groups (p > 0.05). The proportion of samples that a beyond intoxication criterion (10μg/l) for urinary Hg was 42.6%. Spearman’s rank correlation analysis indicates a negative correlation between urinary Hg concentrations and average DNA methylation levels in the DMRs of imprinted genes H19 (rs=﹣0.330, p = 0.000). However, there was no such a correlation found in genes of Peg3 and Meg3. Further, we analyzed of correlation between methylation level at each CpG site of H19 and Hg level, the results showed that three out of 7 CpG sites on H19 DMR, namely CpG2 (rs =﹣0.138, p = 0.031), CpG4 (rs =﹣0.369, p = 0.000) and CpG6 (rs=﹣0.228, p = 0.000), demonstrated a significant negative correlation between methylation levels and the levels of urinary Hg. After adjusting age, smoking, drinking, intake of aquatic products and education by multivariate regression analysis, the results have shown a similar correlation. In summary, mercury nonoccupational environmental exposure in reproductive-aged men associated with altered DNA methylation outcomes at DMR of imprinting gene H19 in sperm, implicating the susceptibility of the developing sperm for environmental insults.

Keywords: epigenetics, genomic imprinting gene, DNA methylation, mercury, transgenerational effects, sperm

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2711 Impacts of Public Insurance on Health Access and Outcomes: Evidence from India

Authors: Titir Bhattacharya, Tanika Chakraborty, Prabal K. De

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Maternal and child health continue to be a significant policy focus in developing countries, including India. An emerging model in health care is the creation of public and private partnerships. Since the construction of physical infrastructure is costly, governments at various levels have tried to implement social health insurance schemes where a trust calculates insurance premiums and medical payments. Typically, qualifying families get full subsidization of the premium and get access to private hospitals, in addition to low cost public hospitals, for their tertiary care needs. We analyze one such pioneering social insurance scheme in the Indian state of Andhra Pradesh (AP). The Rajiv Aarogyasri program (RA) was introduced by the Government of AP on a pilot basis in 2007 and implemented in 2008. In this paper, we first examine the extent to which access to reproductive health care changed. For example, the RA scheme reimburses hospital deliveries leading us to expect an increase in institutional deliveries, particularly in private hospitals. Second, we expect an increase in institutional deliveries to also improve child health outcomes. Hence, we estimate if the program improved infant and child mortality. We use District Level Health Survey data to create annual birth cohorts from 2000-2015. Since AP was the only state in which such a state insurance program was implemented, the neighboring states constituted a plausible control group. Combined with the policy timing, and the year of birth, we employ a difference-indifference strategy to identify the effects of RA on the residents of AP. We perform several checks against threats to identification, including testing for pre-treatment trends between the treatment and control states. We find that the policy significantly lowered infant and child mortality in AP. We also find that deliveries in private hospitals increased, and government hospitals decreased, showing a substitution effect of the relative price change. Finally, as expected, out-of-pocket costs declined for the treatment group. However, we do not find any significant effects for usual preventive care such as vaccination, showing that benefits of insurance schemes targeted at the tertiary level may not trickle down to the primary care level.

Keywords: public health insurance, maternal and child health, public-private choice

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2710 Course Perceiving Differences among College Science Students from Various Cultures: A Case Study in the US

Authors: Yuanyuan Song

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Background: As we all know, culture plays a pivotal role in the realm of education, influencing study perceptions and outcomes. Nevertheless, there remains a need to delve into how culture specifically impacts the perception of courses. Therefore, the impact of culture on students' perceptions and academic performance is explored in this study. Drawing from cultural constructionism and conflict theories, it is posited that when students hailing from diverse cultures and backgrounds converge in the same classroom, their perceptions of course content may diverge significantly. This study seeks to unravel the tangible disparities and ascertain how cultural nuances shape students' perceptions of classroom content when encountering diverse cultural contexts within the same learning environment. Methodology: Given the diverse cultural backgrounds of students within the US, this study draws upon data collected from a course offered by a US college. In pursuit of answers to these inquiries, a qualitative approach was employed, involving semi-structured interviews conducted in a college-level science class in the US during 2023. The interviews encompassed approximately nine questions, spanning demographic particulars, cultural backgrounds, science learning experiences, academic outcomes, and more. Participants were exclusively drawn from science-related majors, with each student originating from a distinct cultural context. All participants were undergraduates, and most of them were from eighteen to twenty-five years old, totaling six students who attended the class and willingly participated in the interviews. The duration of each interview was approximately twenty minutes. Results: The findings gleaned from the interview data underscore the notable impact of varying cultural contexts on students' perceptions. This study argues that female science students, for instance, are influenced by gender dynamics due to the predominant male presence in science majors, creating an environment where female students feel reticent about expressing themselves in public. Students of East Asian origin exhibit a stronger belief in the efficacy of personal efforts when contrasted with their North American counterparts. Minority students indicated that they grapple with integration into the predominantly white mainstream society, influencing their eagerness to engage in classroom activities that are conducted by white professors. All of them emphasized the importance of learning science.

Keywords: multiculture education, educational sociology, educational equality, STEM education

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2709 A Sociolinguistic Study of the Outcomes of Arabic-French Contact in the Algerian Dialect Tlemcen Speech Community as a Case Study

Authors: R. Rahmoun-Mrabet

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It is acknowledged that our style of speaking changes according to a wide range of variables such as gender, setting, the age of both the addresser and the addressee, the conversation topic, and the aim of the interaction. These differences in style are noticeable in monolingual and multilingual speech communities. Yet, they are more observable in speech communities where two or more codes coexist. The linguistic situation in Algeria reflects a state of bilingualism because of the coexistence of Arabic and French. Nevertheless, like all Arab countries, it is characterized by diglossia i.e. the concomitance of Modern Standard Arabic (MSA) and Algerian Arabic (AA), the former standing for the ‘high variety’ and the latter for the ‘low variety’. The two varieties are derived from the same source but are used to fulfil distinct functions that is, MSA is used in the domains of religion, literature, education and formal settings. AA, on the other hand, is used in informal settings, in everyday speech. French has strongly affected the Algerian language and culture because of the historical background of Algeria, thus, what can easily be noticed in Algeria is that everyday speech is characterized by code-switching from dialectal Arabic and French or by the use of borrowings. Tamazight is also very present in many regions of Algeria and is the mother tongue of many Algerians. Yet, it is not used in the west of Algeria, where the study has been conducted. The present work, which was directed in the speech community of Tlemcen-Algeria, aims at depicting some of the outcomes of the contact of Arabic with French such as code-switching, borrowing and interference. The question that has been asked is whether Algerians are aware of their use of borrowings or not. Three steps are followed in this research; the first one is to depict the sociolinguistic situation in Algeria and to describe the linguistic characteristics of the dialect of Tlemcen, which are specific to this city. The second one is concerned with data collection. Data have been collected from 57 informants who were given questionnaires and who have then been classified according to their age, gender and level of education. Information has also been collected through observation, and note taking. The third step is devoted to analysis. The results obtained reveal that most Algerians are aware of their use of borrowings. The present work clarifies how words are borrowed from French, and then adapted to Arabic. It also illustrates the way in which singular words inflect into plural. The results expose the main characteristics of borrowing as opposed to code-switching. The study also clarifies how interference occurs at the level of nouns, verbs and adjectives.

Keywords: bilingualism, borrowing, code-switching, interference, language contact

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