Search results for: evidence based medicine

Authors: Ramona-Niculina Jurcau, Ioana-Marieta Jurcau, Dong Hun Kwak, Nicolae-Alexandru Colceriu

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Background: Stress management (SM) is a topic of great academic interest and equally a task to accomplish. In addition, it is recognized the beneficial role of unconventional therapies (UCT) in stress modulation. Aims: The aim was to evaluate medical (MS) versus non-medical students’ (NMS) opinions about academic stress management (ASM) using UCT. Methods: MS (n=103, third year males and females) and NMS (n=112, males and females, from humanities faculties, different years of study), out of their academic program, voluntarily answered to a questionnaire concerning: a) Classification of the four most important academic stress factors; b) The extent to which their daily life influences academic stress; c) The most important SM methods they know; d) Which of these methods they are applying; e) the UCT they know or about which they have heard; f) Which of these they know to have stress modulation effects; g) Which of these UCT, participants are using or would like to use for modulating stress; and if participants use UTC for their own choose or following a specialist consultation in those therapies (SCT); h) If they heard about the following UCT and what opinion they have (using visual analogue scale) about their use (following CST) for the ASM: Phytotherapy (PT), apitherapy (AT), homeopathy (H), ayurvedic medicine (AM), traditional Chinese medicine (TCM), music therapy (MT), color therapy (CT), forest therapy (FT). Results: Among the four most important academic stress factors, for MS more than for NMS, are: busy schedule, large amount of information taught; high level of performance required, reduced time for relaxing. The most important methods for SM that MS and NMS know, hierarchically are: listen to music, meeting friends, playing sport, hiking, sleep, regularly breaks, seeing positive side, faith; of which, NMS more than MS, are partially applying to themselves. UCT about which MS and less NMS have heard, are phytotherapy, apitherapy, acupuncture, reiki. Of these UTC, participants know to have stress modulation effects: some plants, bee’s products and music; they use or would like to use for ASM (the majority without SCT) certain teas, honey and music. Most of MS and only some NMS heard about PT, AT, TCM, MT and much less about H, AM, CT, TT. NMS more than MS, would use these UCT, following CST. Conclusions: 1) Academic stress is similarly reflected in MS and NMS opinions. 2) MS and NMS apply similar but very few UCT for stress modulation. 3) Information that MS and NMS have about UCT and their ASM application is reduced. 4) It is remarkable that MS and especially NMS, are open to UCT use for ASM, following an SCT.

Keywords: academic stress, stress management, stress modulation, medical students, non-medical students, unconventional therapies

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Authors: Zeineb Ben Salem, Wissem Frikha, Mounir Bouassida

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The aim of this paper is to assess the effectiveness of stone columns as a liquefaction countermeasure focusing on shear reinforcementbenefit. In fact, stone columns which have high shear modulus relative to the surrounding soils potentially can carry higher shear stress levels. Thus, stone columns provide shear reinforcement and decrease the Cyclic Shear Stress Ratio CSR to which the treated soils would be subjected during an earthquake. In order to quantify the level of shear stress reduction in reinforced soil, several approaches have been developed. Nevertheless, the available approaches do not take into account the improvement of the soil parameters, mainly the shear modulusdue to stone columns installation. Indeed, in situ control tests carried out before and after the installation of stone columns based upon the results of collected data derived from 24 case histories have given evidence of the improvement of the existing soil properties.In this paper, the assessment of shear reinforcement of stone columns that accounts such improvement of the soil parameters due to stone column installation is investigated. Comparative results indicate that considering the improvement effects considerably affect the assessment of shear reinforcement for liquefaction analysis of reinforced soil by stone columns.

Keywords: stone column, liquefaction, shear reinforcement, CSR, soil improvement

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Authors: Verónica Díaz Quezada

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The importance given to the development of the problem solving skill and the requirement to solve problems framed in mathematical or real life contexts, in practice, they are not evidence in relation to the teaching of proportional variations. This qualitative and descriptive study aims to (1) to improve problem solving ability of high school students in Chile, (ii) to elaborate and describe a didactic intervention strategy based on learning situations in proportional variations, focused on solving types of routine problems of various contexts and non-routine problems. For this purpose, participant observation was conducted, test of mathematics problems and an opinion questionnaire to thirty-six high school students. Through the results, the highest academic performance is evidenced in the routine problems of purely mathematical context, realistic, fantasy context, and non-routine problems, except in the routine problems of real context and compound proportionality problems. The results highlight the need to consider in the curriculum different types of problems in the teaching of mathematics that relate the discipline to everyday life situations

Keywords: algebra, high school, proportion variations, nonroutine problem solving, routine problem solving

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Authors: Aziza Barnawi

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Background: Regular exercise reduces risk factors associated with cardiovascular diseases. Over the past decade, exercise interventions have been introduced to reduce the risk of and prevent coronary artery disease (CAD). Elevated low-density lipoproteins (LDL) contribute to the formation of atherosclerosis, its manifestations on the endothelial narrow the coronary artery and affect the endothelial function. Therefore, flow-mediated dilation (FMD) technique is used to assess the function. The results of previous studies have been inconsistent and difficult to interpret across different types of exercise programs. The relationship between exercise therapy and lipid levels has been extensively studied, and it is known to improve the lipid profile and endothelial function. However, the effectiveness of exercise in altering LDL levels and improving blood flow is controversial. Objective: This review aims to explore the evidence and quantify the impact of exercise training on LDL levels and vascular function by FMD. Methods: Electronic databases were searched PubMed, Google Scholar, Web of Science, the Cochrane Library, and EBSCO using the keywords: “low and/or moderate aerobic training”, “blood flow”, “atherosclerosis”, “LDL mediated blood flow”, “Cardiac Rehabilitation”, “low-density lipoproteins”, “flow-mediated dilation”, “endothelial function”, “brachial artery flow-mediated dilation”, “oxidized low-density lipoproteins” and “coronary artery disease”. The studies were conducted for 6 weeks or more and influenced LDL levels and/or FMD. Studies with different intensity training and endurance training in healthy or CAD individuals were included. Results: Twenty-one randomized controlled trials (RCTs) (14 FMD and 7 LDL studies) with 776 participants (605 exercise participants and 171 control participants) met eligibility criteria and were included in the systematic review. Endurance training resulted in a greater reduction in LDL levels and their subfractions and a better FMD response. Overall, the training groups showed improved physical fitness status compared with the control groups. Participants whose exercise duration was ≥150 minutes /week had significant improvement in FMD and LDL levels compared with those with <150 minutes/week.Conclusion: In conclusion, although the relationship between physical training, LDL levels, and blood flow in CAD is complex and multifaceted, there are promising results for controlling primary and secondary prevention of CAD by exercise. Exercise training, including resistance, aerobic, and interval training, is positively correlated with improved FMD. However, the small body of evidence for LDL studies (resistance and interval training) did not prove to be significantly associated with improved blood flow. Increasing evidence suggests that exercise training is a promising adjunctive therapy to improve cardiovascular health, potentially improving blood flow and contributing to the overall management of CAD.

Keywords: exercise training, low density lipoprotein, flow mediated dilation, coronary artery disease

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Authors: Joshua Abraham, Craig Wales

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Abstract—SIGN Guideline 122 recommends that all patients who are admitted to hospital are assessed for venous thromboembolism risk within 24 hours of admission. NHS Greater Glasgow and Clyde provide guidance on this in the form of a proforma. Patients are then subsequently prescribed either thrombo-embolic-deterrent stockings (TEDS)/low molecular weight heparin (LMWH) for the prevention of VTE based on their score. A retrospective casenote audit of a random sample of fifty oncology and trauma inpatients at the QEUH in December 2019 was performed. 90% of patients had a risk assessment conducted as evidenced by a completed proforma. In 78% of these patients, the proforma fully completed. Overall 94% of patients had some for of thromboprophylaxis prescribed in the form of TEDS or LMWH. A lack of 100% compliance against the given standards highlighted potential implications for patient safety, but also medico-legal ramifications for staff. Clinical judgement can only be relied upon if there is written documentation as evidence. Further staff education and the suggestion of a written prompt to the clerk-in documentation will hopefully improve compliance, whilst a repeat audit should demonstrate any improvement.

Keywords: Maxillofacial , Thromboembolism, Thromboprophylaxis , Prescription

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Authors: Kalin Ivanov, Stanislava Ivanova

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Actoprotectors are substances with hight performance enchasing potential and hight antioxidant activity. Most of these drugs have been developed in USSR for military medicine purposes. Based on their chemical composition actoprotectors could be classified into three categories: benzimidazole derivatives (ethomersol, bemitil); adamantane derivatives (bromantane), other chemical classes. First data for intake of actoprotectors from professional athletes is from 1980. The daily intake of actoprotectors demonstrate many benefits for athletes like: positive effect on the efficiency of physical work, antihypoxic effects, antioxidant effects, nootropic effects, rapid recovery. Since 1997, bromantane is considered as doping. This is a result of Summer Olympic Games in Athlanta (1996) when several Russian athletes tested positive for bramantane. Even the drug is safe for athletes health its use is considered as violation of anti- doping rules. More than 37 years bemetil has been used by professional athletes with no risk but currently it is included in WADA monitoring programme for 2018. Current perspectives are that most used actoprotectors would be considered as doping. Many clinical studies have confirmed that intake of bemitil and bromantan demonstrate positive influence on the physical work capacity but data for other actoprotectors like chlodantane, ademol, ethomersol is limited.

Keywords: actoprotector, sport, doping, bemitil

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Authors: Yifan Zheng, Jinmin Zhu, Jiji Li, Gulling Li, Huahong Shi

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Secondary microplastics originate from the fragmentation of large plastics, and weathering is supposed to be the main cause of fragmentation. In this study, we investigated burrows and burrowing invertebrates on Styrofoam floats from the mariculture areas of China’s coastal waters. Various burrows were found on the submerged surface of Styrofoam floats and could be divided into ‘I’, ‘S’, ‘J’, and ‘Y’ types based on the burrow entrance number and passage curvature. Different invertebrate species, including 5 isopods, 8 clamworms, and 12 crabs, were found inside the burrows. Micro-foams were found in the bodies of these burrowers, with an average abundance of 4.2 ± 0.3 (isopod), 6.9 ± 2.0 (clamworm), and 3.0 ± 0.5 (crab) micro-foams per individual. In the laboratory, we observed the boring process of crabs in abandoned floats. Field and laboratory evidence suggested that these invertebrates bored various burrows. The total volume of crab burrows on a 3-year-used float was estimated to be 2.6 × 10³ cm³, producing 4.1 × 10⁸ microplastics. This study highlights the critical role of bioerosion in destroying man-made substrates and prompting microplastic pollution.

Keywords: burrowing invertebrate, mariculture area, styrofoam float, fragmentation, microplastics

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Authors: Alexandra McKinzie, Lucy Brown, Sarah Komanapalli, Sarah Swiezy, Caitlin Bernard

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Background: While 25% of US women will seek an abortion before age 45, targeted laws have led to a decline in abortion clinics, subsequently leaving 96% of Indiana counties and the 70% of Hoosier women residing in these counties without access to services they desperately need.1,2 Despite the need for a physician workforce that is educated and able to provide full-spectrum reproductive health care, few medical institutions have a standardized family planning and abortion pre-clinical curriculum. Methods: A Qualtrics survey was disseminated to students from Indiana University School of Medicine (IUSM) to evaluate (1) student interest in curriculum reform, (2) self-assessed preparedness to counsel on contraceptive and pregnancy options, and (3) preferred modality of instruction for family planning and abortion topics. Based on the pre-panel survey feedback, a case-based pregnancy options counseling panel will be implemented in the students’ pre-clinical, didactic course Endocrine, Reproductive, Musculoskeletal, Dermatologic Systems (ERMD) in February 2022. A Qualtrics post-panel survey will be disseminated to evaluate students’ perceived efficacy and quality of the panel, as well as their self-assessed preparedness to counsel on pregnancy options. Results: Participants in the pre-panel survey (n=303) were primarily female (61.72%) and White (74.43%). Across all class levels, many (60.80%) students expected to learn about family planning and abortion in their pre-clinical education. While most (84-88%) participants felt prepared to counsel about common, non-controversial pharmacotherapies (e.g. beta-blockers and diuretics), only 20% of students felt prepared to counsel on abortion options. Overall, 85.67% of students believed that IUSM should enhance its reproductive health coverage in pre-clinical, didactic courses. Traditional lectures, panels, and direct clinical exposure were the most popular instructional modalities. Expected Results: The authors predict that following the panel, students will indicate improved confidence in providing pregnancy options counseling. Additionally, students will provide constructive feedback on the structure and content of the panel for incorporation into future years’ curriculum. Conclusions: IUSM students overwhelmingly expressed interest in expanding their pre-clinical curriculum’s coverage of family planning and abortion topics. To specifically improve students’ self-assessed preparedness to provide pregnancy options counseling and address students’ self-cited learning gaps, a case-based provider panel session will be implemented in response to students’ preferred modality feedback.

Keywords: options counseling, family planning, abortion, curriculum reform, case-based panel

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Authors: Mohamed Haffar, Lois Farquharson, Gbola Gbadamosi, Wafi Al-Karaghouli, Ramadane Djbarni

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A few recent research studies and mostly conceptual in nature have paid attention to the relationship between organizational culture (OC), individual readiness for change (IRFC) and individual affective commitment to change (IACC). Surprisingly enough, there is a lack of empirical studies investigating the influence of all four OC types on IRFC and IACC. Moreover, there is a very limited research investigating the mediating role of individual readiness for change between OC types and individual affective commitment to change. Therefore, this study is proposed to fill this gap by providing empirical evidence leading to advancement in the understanding of direct and indirect influences of OC on individual affective commitment to change. To achieve this, a questionnaire based survey was developed and self-administered to 226 middle managers in Algerian manufacturing organizations (AMOs). The results of this study indicated that group culture and adhocracy culture positively affect the IACC. Furthermore, the findings of this study show support for the mediating roles of self-efficacy and personally valence in the relationship between OC and IACC.

Keywords: individual readiness for change, individual commitment to change, organisational culture, manufacturing organisations

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Authors: Anxuan Xie, Chun-Chan Yu

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Survey evidence provides support that auditors can gain professional knowledge not only from client firms but also from teammates they work with. Furthermore, given that knowledge is accumulated in nature, along with the reality that auditors today must work in an environment of increased diversity, whether the attributes of teammates will influence the effects of knowledge sharing and accumulation and ultimately influence an audit partner’s audit quality should be interesting research issues. We test whether the gender of co-signers will moderate the effect of a lead partner’s cooperative experiences on financial restatements. Furthermore, if the answer is “yes”, we further investigate the underlying reasons. We use data from Taiwan because, according to Taiwan’s law, engagement partners, who are basically two certificate public accountants from the same audit firm, are required to disclose (i.e., sign) their names in the audit report of public companies since 1983. Therefore, we can trace each engagement partner’s historic direct cooperative (co-signing) records and get large-sample data. We find that the benefits of knowledge sharing manifest primarily via co-signing audit reports with audit partners of different gender from the lead engagement partners, supporting the argument that in an audit setting, accumulated gender-diverse working relationship is positively associated with knowledge sharing, and therefore improve lead engagements’ audit quality. This study contributes to the extant literature in the following ways. First, we provide evidence that in the auditing setting, the experiences accumulated from cooperating with teammates of a different gender from the lead partner can improve audit quality. Given that most studies find evidence of negative effects of surface-level diversity on team performance, the results of this study support the prior literature that the association between diversity and knowledge sharing actually hinges on the context (e.g., organizational culture, task complexity) and “bridge” (a pre-existing commonality among team members that can smooth the process of diversity toward favorable results) among diversity team members. Second, this study also provides practical insights with respect to the audit firms’ policy of knowledge sharing and deployment of engagement partners. For example, for audit firms that appreciate the merits of knowledge sharing, the deployment of auditors of different gender within an audit team can help auditors accumulate audit-related knowledge, which will further benefit the future performance of those audit firms. Moreover, nowadays, client firms also attach importance to the diversity of their engagement partners. As their policy goals, lawmakers and regulators also continue to promote a gender-diverse working environment. The findings of this study indicate that for audit firms, gender diversity will not be just a means to cater to those groups. Third, for audit committees or other stakeholders, they can evaluate the quality of existing (or potential) lead partners by tracking their co-signing experiences, especially whether they have gender-diverse co-signing experiences.

Keywords: co-signing experiences, audit quality, knowledge sharing, gender diversity

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Authors: Virginia Guillén Cañas, Miren Agurtzane Ortiz-Jauregi, Sonia Ruiz De Azua, Naiara Ozamiz

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We want to focus on relationship of the communicational skills in several key aspects of medicine. The most relevant competencies of a health professional are an adequate communication capacity, which will influence the satisfaction of professionals and patients, therapeutic compliance, conflict prevention, clinical outcomes’ improvement and efficiency of health services. We define empathy as it as Sympathy and connection to others and capability to communicate this understanding. Some outcomes favoring empathy are female gender, younger age, and specialty choice. Third gender or third sex is a concept in which allows a person not to be categorized in a dual way but as a continuous variable, giving the choice of moving along it. This point of view recognizes three or more genders. The subject of Ethics and Clinical Communication is dedicated to sensitizing students about the importance and effectiveness of a good therapeutic relationship. We are also interested in other communicational aspects related to empathy as active listening, assertivity and basic and advanced Social Skills. Objectives: 1. To facilitate the approach of the student in the Medicine Degree to the reality of the medical profession 2. Analyze interesting outcome variables in communication 3. Interactive process to detect the areas of improvement in the learning process of the Physician throughout his professional career needs. Design: A comparative study with a cross-sectional approach was conducted in successive academic year cohorts of health professional students at a public Basque university. Four communicational aspects were evaluated through these questionnaires in Basque, Spanish and English: The active listening questionnaire, the TECA empathy questionnaire, the ACDA questionnaire and the EHS questionnaire Social Skills Scale. Types of interventions for improving skills: Interpersonal skills training intervention, Empathy intervention, Writing about experiential learning, Drama through role plays, Communicational skills training, Problem-based learning, Patient interviews ´videos, Empathy-focused training, Discussion. Results: It identified the need for a cross cultural adaptation and no gender distinction. The students enjoyed all the techniques in comparison to the usual master class. There was medium participation but these participative methodologies are not so usual in the university. According to empathy, men have a greater empathic capacity to fully understand women (p < 0.05) With regard to assertiveness there have been no differences between men and women in self-assertiveness but nevertheless women are more heteroassertive than men. Conclusions: These findings suggest that educational interventions with adequate feedback can be effective in maintaining and enhancing empathy in undergraduate medical students.

Keywords: physician's communicational skills, patient satisfaction, third gender, cross cultural adaptation

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Authors: Yi Ding

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With the upsurge of Chinese international students in American higher education, serious academic problems Chinese international students are suffering from are also striking. While most practices and research in higher education focus on the role of professors, writing centers, and tutoring centers to help international students succeed in college, this research study focuses on a more fundamental skill that is neglected in most conversations: information literacy, which is usually addressed by academic librarians. Transitioning from an East-Asian, developing educational system that values authority, set knowledge more than independent thinking, scholarly conversation, Chinese international students need support from academic librarians to acquire information literacy, which is crucial to understand expectations of a Western academic setting and thus to succeed in college. This research study illustrates how academic librarians can play an integral role in helping Chinese international students acclimate to the expectations of American higher education by teaching information literacy as academic literacy unique to the Western academic setting. Six keys of information literacy put forward by Association of College and Research Libraries, which are 'Authority Is Constructed and Contextual', 'Information Creation as a Process', 'Information Has Value', 'Research as Inquiry', 'Scholarship as Conversation', and 'Searching as Strategic Exploration', are analyzed through the lens of Chinese educational system and students’ backgrounds. Based on the analysis as well as results from surveys and interviews among academic librarians, professors, and international students, this research further examines current practices from a wide range of academic libraries and finally, provides evidence-based recommendations for academic librarians to use information literacy instruction to help Chinese international students succeed in American higher education.

Keywords: academic librarians, Chinese international students, information literacy, student success

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Authors: Malik Shahzad Shabbir, Muhammad Saarim Ghazi, Amir Khalil ur Rehman

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This study examines the factors which influence and contribute towards the financial viability of Islamic finance and its impact on global financial stability. However, the purpose of this paper is to differentiate the practical implications of both Islamic and conventional finance on global financial stability. The Islamic finance is asset backed financing which creates wealth through trade, commerce and believes in risk and return sharing. Islamic banking is asset driven as against to conventional banking which is liability driven. In order to introduce new financial products for market, financial innovation in Islamic finance must be within the Shari’ah parameters that are tested against the ‘Maqasid al-Shari’ah’. Interest-based system leads to income and wealth inequalities and mis-allocation of resources. Moreover, this system has absence of just and equitable aspect of distribution that may exploit either the debt holder or the financier. Such implications are reached to a tipping point that leaves only one choice: change or face continued decline and misery.

Keywords: viability, global financial stability, practical implications, asset driven, tipping point

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Authors: Rawan Hakawati, Beatrice Smyth, David Rooney, Geoffrey McCullough

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Targets have been set in the EU to increase the share of renewable energy consumption to 20% by 2020, but developments have not occurred evenly across the member states. Northern Ireland is almost 90% dependent on imported fossil fuels. With such high energy dependency, Northern Ireland is particularly susceptible to the security of supply issues. Linked to fossil fuels are greenhouse gas emissions, and the EU plans to reduce emissions by 20% by 2020. The use of indigenously produced biomass could reduce both greenhouse gas emissions and external energy dependence. With a wide range of both crop and waste feedstock potentially available in Northern Ireland, anaerobic digestion has been put forward as a possible solution for renewable energy production, waste management, and greenhouse gas reduction. Not all feedstock, however, is the same, and an understanding of feedstock suitability is important for both plant operators and policy makers. The aim of this paper is to investigate biomass suitability for anaerobic digestion in Northern Ireland. It is also important that decisions are based on solid scientific evidence. For this reason, the methodology used is multi-criteria decision matrix analysis which takes multiple criteria into account simultaneously and ranks alternatives accordingly. The model uses the weighted sum method (which follows the Entropy Method to measure uncertainty using probability theory) to decide on weights. The Topsis method is utilized to carry out the mathematical analysis to provide the final scores. Feedstock that is currently available in Northern Ireland was classified into two categories: wastes (manure, sewage sludge and food waste) and energy crops, specifically grass silage. To select the most suitable feedstock, methane yield, feedstock availability, feedstock production cost, biogas production, calorific value, produced kilowatt-hours, dry matter content, and carbon to nitrogen ratio were assessed. The highest weight (0.249) corresponded to production cost reflecting a variation of £41 gate fee to 22£/tonne cost. The weights calculated found that grass silage was the most suitable feedstock. A sensitivity analysis was then conducted to investigate the impact of weights. The analysis used the Pugh Matrix Method which relies upon The Analytical Hierarchy Process and pairwise comparisons to determine a weighting for each criterion. The results showed that the highest weight (0.193) corresponded to biogas production indicating that grass silage and manure are the most suitable feedstock. Introducing co-digestion of two or more substrates can boost the biogas yield due to a synergistic effect induced by the feedstock to favor positive biological interactions. A further benefit of co-digesting manure is that the anaerobic digestion process also acts as a waste management strategy. From the research, it was concluded that energy from agricultural biomass is highly advantageous in Northern Ireland because it would increase the country's production of renewable energy, manage waste production, and would limit the production of greenhouse gases (current contribution from agriculture sector is 26%). Decision-making methods based on scientific evidence aid policy makers in classifying multiple criteria in a logical mathematical manner in order to reach a resolution.

Keywords: anaerobic digestion, biomass as feedstock, decision matrix, renewable energy

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Authors: Roni Ramon-Gonen, Amir Dori, Shahar Shelly

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Background and objectives: Healthcare professionals produce abundant textual information in their daily clinical practice. The extraction of insights from all the gathered information, mainly unstructured and lacking in normalization, is one of the major challenges in computational medicine. In this respect, text mining assembles different techniques to derive valuable insights from unstructured textual data, so it has led to being especially relevant in Medicine. Neurological patient’s history allows the clinician to define the patient’s symptoms and along with the result of the nerve conduction study (NCS) and electromyography (EMG) test, assists in formulating a differential diagnosis. Past medical history (PMH) helps to direct the latter. In this study, we aimed to identify relevant PMH, understand which PMHs are common among patients in the referral cohort and documented by the medical staff, and examine the differences by sex and age in a large cohort based on textual format notes. Methods: We retrospectively identified all patients with abnormal NCS between May 2016 to February 2022. Age, gender, and all NCS attributes reports were recorded, including the summary text. All patients’ histories were extracted from the text report by a query. Basic text cleansing and data preparation were performed, as well as lemmatization. Very popular words (like ‘left’ and ‘right’) were deleted. Several words were replaced with their abbreviations. A bag of words approach was used to perform the analyses. Different visualizations which are common in text analysis, were created to easily grasp the results. Results: We identified 5282 unique patients. Three thousand and five (57%) patients had documented PMH. Of which 60.4% (n=1817) were males. The total median age was 62 years (range 0.12 – 97.2 years), and the majority of patients (83%) presented after the age of forty years. The top two documented medical histories were diabetes mellitus (DM) and surgery. DM was observed in 16.3% of the patients, and surgery at 15.4%. Other frequent patient histories (among the top 20) were fracture, cancer (ca), motor vehicle accident (MVA), leg, lumbar, discopathy, back and carpal tunnel release (CTR). When separating the data by sex, we can see that DM and MVA are more frequent among males, while cancer and CTR are less frequent. On the other hand, the top medical history in females was surgery and, after that, DM. Other frequent histories among females are breast cancer, fractures, and CTR. In the younger population (ages 18 to 26), the frequent PMH were surgery, fractures, trauma, and MVA. Discussion: By applying text mining approaches to unstructured data, we were able to better understand which medical histories are more relevant in these circumstances and, in addition, gain additional insights regarding sex and age differences. These insights might help to collect epidemiological demographical data as well as raise new hypotheses. One limitation of this work is that each clinician might use different words or abbreviations to describe the same condition, and therefore using a coding system can be beneficial.

Keywords: abnormal studies, healthcare analytics, medical history, nerve conduction studies, text mining, textual analysis

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Authors: Elizabeth Valenti

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Objective: To date, there remains an absence of literature examining perceptions of mindfulness and mindful practices among college students, particularly among Christian students. The purpose of this mixed-methods, exploratory study was to gain a better understanding of students’ perception of mindfulness and assess current mindful practices. Methods: The mixed-methods, exploratory study examined data from freshmen undergraduate college students (N=107) enrolled in an introductory psychology course at a private, non-profit Christian university. Students completed a researcher-developed questionnaire containing both Likert and opened ended questions to assess knowledge about and perceptions of mindfulness, as well as current mindful practices. Results: Results of the thematic analysis revealed approximately half of the students had a limited understanding of mindfulness, with several reporting disadvantages. Most students listed prayer as a consistent practice, with a much smaller percentage of students consistently engaging in other mindful activities. Discussion: Implications for mindfulness education and the promotion of evidence-based methods, particularly in Christian communities, are discussed.

Keywords: mindfulness, mindful practices, perception, Christian, university students, mental health

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Authors: Jacob Nortey

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Introduction: In recent years, there has been an enormous success in discoveries of scientific knowledge in medicine coupled with the advancement of technology. Despite all these successes, diagnoses and treatment of diseases have become complex. According to the Ibero – American Study of Adverse Effects (IBEAS), about 10% of hospital patients suffer from secondary damage during the care process, and approximately 2% die from this process. Many clinical decision support systems have been developed to help mitigate some healthcare medical errors. Method: Relevant databases were searched, including ones that were peculiar to the clinical decision support system (that is, using google scholar, Pub Med and general google searches). The articles were then screened for a comprehensive overview of the functionality, consultative style and statistical usage of Dxplain Clinical decision support systems. Results: Inferences drawn from the articles showed high usage of Dxplain clinical decision support system for problem-based learning among students in developed countries as against little or no usage among students in Low – and Middle – income Countries. The results also indicated high usage among general practitioners. Conclusion: Despite the challenges Dxplain presents, the benefits of its usage to clinicians and students are enormous.

Keywords: dxplain, clinical decision support sytem, diagnosis, support systems

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Authors: Oluwatoyin Joseph Gbadeyan, Sarp Adali, Bright Glen, Bruce Sithole

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Sodium lauryl surfactant concentration optimization, for nanoparticle production, provided the platform for advanced research studies. Different concentrations (0.05 %, 0.1 %, and 0.2 %) of sodium lauryl surfactant was added to snail shells powder during milling processes for producing CaCO3 at smaller particle size. Epoxy nanocomposites prepared at filler content 2 wt.% synthesized with different volumes of sodium lauryl surfactant were fabricated using a conventional resin casting method. Mechanical properties such as tensile strength, stiffness, and hardness of prepared nanocomposites was investigated to determine the effect of sodium lauryl surfactant concentration on nanocomposite properties. It was observed that the loading of the synthesized nano-calcium carbonate improved the mechanical properties of neat epoxy at lower concentrations of sodium lauryl surfactant 0.05 %. Meaningfully, loading of achatina fulica snail shell nanoparticles manufactures, with small concentrations of sodium lauryl surfactant 0.05 %, increased the neat epoxy tensile strength by 26%, stiffness by 55%, and hardness by 38%. Homogeneous dispersion facilitated, by the addition of sodium lauryl surfactant during milling processes, improved mechanical properties. Research evidence suggests that nano-CaCO3, synthesized from achatina fulica snail shell, possesses suitable reinforcement properties that can be used for nanocomposite fabrication. The evidence showed that adding small concentrations of sodium lauryl surfactant 0.05 %, improved dispersion of nanoparticles in polymetrix material that provided mechanical properties improvement.

Keywords: sodium lauryl surfactant, mechanical properties , achatina fulica snail shel, calcium carbonate nanopowder

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Authors: Seon-Young Lee, Harkiran Sagoo, Reem Farwana, Katharine Whitehurst, Alex Fowler, Riaz Agha

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Background/Aims: Systematic reviews and meta-analysis are becoming increasingly important way of summarizing research evidence. Researches in ophthalmology may represent further challenges, due to their potential complexity in study design. The aim of our study was to determine the reporting quality of systematic reviews and meta-analysis in ophthalmology with the PRISMA statement, by assessing the articles published between 2010 and 2015 from five major journals with the highest impact factor. Methods: MEDLINE and EMBASE were used to search systematic reviews published between January 2010 and December 2015, in 5 major ophthalmology journals: Progress in Retinal and Eye Research, Ophthalmology, Archives of Ophthalmology, American Journal of Ophthalmology, Journal of the American Optometric Association. Screening, identification, and scoring of articles were performed independently by two teams, followed by statistical analysis including the median, range, and 95% CIs. Results: 115 articles were involved. The median PRISMA score was 15 of 27 items (56%), with a range of 5-26 (19-96%) and 95% CI 13.9-16.1 (51-60%). Compliance was highest in items related to the description of rationale (item 3,100%) and inclusion of a structured summary in the abstract (item 2, 90%), while poorest in indication of review protocol and registration (item 5, 9%), specification of risk of bias affecting the cumulative evidence (item 15, 24%) and description of clear objectives in introduction (item 4, 26%). Conclusion: The reporting quality of systematic reviews and meta-analysis in ophthalmology need significant improvement. While the use of PRISMA criteria as a guideline before journal submission is recommended, additional research identifying potential barriers may be required to improve the compliance to the PRISMA guidelines.

Keywords: systematic reviews, meta-analysis, research methodology, reporting quality, PRISMA, ophthalmology

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Authors: Mohammad Mohammadi, Mohammad Pashmchi

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Background: Malnutrition commonly develops and worsens following gastric cancer surgery, particularly after discharge, which is associated with adverse outcomes. Former studies have primarily focused on patients during their hospital stay period, and there is limited evidence regarding the recommendation of nutritional interventions for patients after discharge from the hospital following gastric cancer surgery. This review is aimed to evaluate the efficiency of post-discharge dietary counseling with oral nutritional supplements (ONS), and dietary counseling alone on post-surgical nutritional outcomes in patients undergoing gastric cancer surgery. Methods: The four databases of Embase, PubMed, web of science, and google scholar were searched up to November 2022 for relevant randomized controlled trials. The Cochrane Collaboration’s assessment tool for randomized trials was used to evaluate the quality of studies. Results: Compared to patients who only received dietary counseling, patients who received both dietary counseling and ONS had considerably higher SMI, BMI, and less weight loss and sarcopenia occurrence rate. The patients who had received dietary counseling and ONS had significantly lower risk of chemotherapy intolerance. No differences in the readmission rate between the two groups was found. In terms of the quality of life, concomitant dietary advice and ONS significantly was associated with lower appetite loss and fatigue rate, but there was no difference in the other outcomes between the two groups. Conclusions: Post-discharge dietary advice with ONS following gastric cancer surgery may improve skeletal muscle maintenance, nutritional outcomes, quality of life variables, and chemotherapy tolerance. This evidence supports the recommendation of post-discharge dietary advice with ONS for patients who underwent gastric cancer surgery.

Keywords: gastric cancer surgery, oral nutritional supplements, malnutrition, gastric cancer

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Authors: Mengxia Jin, Yongqiang Chen, Wenqian Wang, Yu Wang

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The complexity and specificity of construction projects have made common opportunism phenomenon, and contractual governance for opportunism has been a topic of considerable ongoing research. Based on TCE, the research distinguishes control and coordination as different functions of the contract to investigate their complexity separately. And in a nuanced way, the dimensionality of contractual control is examined. Through the analysis of motivation and capability of strong or weak form opportunism, the framework focuses on the relationship between the complexity of above contractual dimensions and different types of opportunistic behavior and attempts to verify the possible explanatory mechanism. The explanatory power of the research model is evaluated in the light of empirical evidence from questionnaires. We collect data from Chinese companies in the construction industry, and the data collection is still in progress. The findings will speak to the debate surrounding the effects of contract complexity on opportunistic behavior. This nuanced research will derive implications for research on the role of contractual mechanisms in dealing with inter-organizational opportunism and offer suggestions for curbing contract parties’ opportunistic behavior in construction projects.

Keywords: contractual complexity, contractual control, contractual coordinatio, opportunistic behavior

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Authors: Eric Sanchis

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Although there does not exist a definitive consensus on a precise definition of a complex system, it is generally considered that a system is complex by nature. The presented work illustrates a different point of view: a system becomes complex only with regard to the question posed to it, i.e., with regard to the problem which has to be solved. A complex system is a couple (question, object). Because the number of questions posed to a given object can be potentially substantial, complexity does not present a uniform face. Two types of complex systems are clearly identified: first-order complex systems and second-order complex systems. First-order complex systems physically exist. They are well-known because they have been studied by the scientific community for a long time. In second-order complex systems, complexity results from the system composition and its articulation that are partially unknown. For some of these systems, there is no evidence of their existence. Vagueness is the keyword characterizing this kind of systems. Autonomy and free will, two mental productions of the human cognitive system, can be identified as second-order complex systems. A classification based on the properties structure makes it possible to discriminate complex properties from the others and to model this kind of second order complex systems. The final outcome is an implementable synthetic property that distinguishes the solid aspects of the actual property from those that are uncertain.

Keywords: autonomy, free will, synthetic property, vaporous complex systems

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Authors: Mahani Razali, Abd Halim Masnan, Nordin Mamat, Seah Siok Peh

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This research is based on three main objectives which are to identify children`s social interaction behaviour during computer play activities, teacher’s role and to explore teacher’s beliefs, views and knowledge about computers use in four Malaysian pre-schools.This qualitative study was carried out among 25 pre-school children and three teachers as the research sample. The data collection procedures involved structured observation which was to identify social interaction behavior among pre-school children through computer play activities; as for semi-structured interviews, it was done to study the perception of the teachers on the acquired of social interaction behavior development among the children. A variety of patterns can be seen within the peer interactions indicating that children exhibit a vast range of social interactions at the computer, and they varied each day. The findings of this study guide us to certain conclusions, which have implications in understanding the phenomena of how computers were used and how its relationship to the children’s social interactions emerge in the four Malaysian preschools. This study provides evidence that the children’s social interactions with peers and adults were mediated by the engagement of the children in the computer environments.

Keywords: computer, play, preschool, social interaction

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Authors: Caroline Smith, Professor Debi Bhattacharya, Sion Scott

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Introduction: Oropharyngeal Dysphagia (OD) effects around 15% of older people, however it is often unrecognised and under diagnosed until they are hospitalised. There is a need for primary care healthcare practitioners (HCPs) to assume a proactive role in identifying and managing OD to prevent adverse outcomes such as aspiration pneumonia. Understanding the determinants of primary care HCPs undertaking this new behaviour provides the intervention targets for addressing. This realist review, underpinned by the Theoretical Domains Framework (TDF), aims to synthesise relevant literature and develop programme theories to understand what interventions work, how they work and under what circumstances to facilitate HCPs to prevent harm from OD. Combining realist methodology with behavioural science will permit conceptualisation of intervention components as theoretical behavioural constructs, thus informing the design of a future behaviour change intervention. Furthermore, through the TDF’s linkage to a taxonomy of behaviour change techniques, we will identify corresponding behaviour change techniques to include in this intervention. Methods & analysis: We are following the five steps for undertaking a realist review: 1) clarify the scope 2) Literature search 3) appraise and extract data 4) evidence synthesis 5) evaluation. We have searched Medline, Google scholar, PubMed, EMBASE, CINAHL, AMED, Scopus and PsycINFO databases. We are obtaining additional evidence through grey literature, snowball sampling, lateral searching and consulting the stakeholder group. Literature is being screened, evaluated and synthesised in Excel and Nvivo. We will appraise evidence in relation to its relevance and rigour. Data will be extracted and synthesised according to its relation to Initial programme theories (IPTs). IPTs were constructed after the preliminary literature search, informed by the TDF and with input from a stakeholder group of patient and public involvement advisors, general practitioners, speech and language therapists, geriatricians and pharmacists. We will follow the Realist and Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) quality and publication standards to report study results. Results: In this ongoing review our search has identified 1417 manuscripts with approximately 20% progressing to full text screening. We inductively generated 10 IPTs that hypothesise practitioners require: the knowledge to spot the signs and symptoms of OD; the skills to provide initial advice and support; and access to resources in their working environment to support them conducting these new behaviours. We mapped the 10 IPTs to 8 TDF domains and then generated a further 12 IPTs deductively using domain definitions to fulfil the remaining 6 TDF domains. Deductively generated IPTs broadened our thinking to consider domains such as ‘Emotion,’ ‘Optimism’ and ‘Social Influence’, e.g. If practitioners perceive that patients, carers and relatives expect initial advice and support, then they will be more likely to provide this, because they will feel obligated to do so. After prioritisation with stakeholders using a modified nominal group technique approach, a maximum of 10 IPTs will progress to test against the literature.

Keywords: behaviour change, deglutition disorders, primary healthcare, realist review

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Authors: Joanna Skopinska-Wisniewska, Anna Bajek, Marta Ziegler-Borowska, Alina Sionkowska

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Hydrogels are a class of materials widely used in medicine for many years. Proteins, such as collagen, due to the presence of a large number of functional groups are easily wettable by polar solvents and can create hydrogels. The supramolecular network capable to swelling is created by cross-linking of the biopolymers using various reagents. Many cross-linking agents has been tested for last years, however, researchers still are looking for a new, more secure reactants. Squaric acid, 3,4-dihydroxy 3-cyclobutene 1,2- dione, is a very strong acid, which possess flat and rigid structure. Due to the presence of two carboxyl groups the squaric acid willingly reacts with amino groups of collagen. The main purpose of this study was to investigate the influence of addition of squaric acid on the chemical, physical and biological properties of collagen materials. The collagen type I was extracted from rat tail tendons and 1% solution in 0.1M acetic acid was prepared. The samples were cross-linked by the addition of 5%, 10% and 20% of squaric acid. The mixtures of all reagents were incubated 30 min on magnetic stirrer and then dialyzed against deionized water. The FTIR spectra show that the collagen structure is not changed by cross-linking by squaric acid. Although the mechanical properties of the collagen material deteriorate, the temperature of thermal denaturation of collagen increases after cross-linking, what indicates that the protein network was created. The lyophilized collagen gels exhibit porous structure and the pore size decreases with the higher addition of squaric acid. Also the swelling ability is lower after the cross-linking. The in vitro study demonstrates that the materials are attractive for 3T3 cells. The addition of squaric acid causes formation of cross-ling bonds in the collagen materials and the transparent, stiff hydrogels are obtained. The changes of physicochemical properties of the material are typical for cross-linking process, except mechanical properties – it requires further experiments. However, the results let us to conclude that squaric acid is a suitable cross-linker for protein materials for medicine and tissue engineering.

Keywords: collagen, squaric acid, cross-linking, hydrogel

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Authors: Azza EL-Medany, Jamila EL-Medany

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Lung fibrosis is a common side effect of the chemotherapeutic agent, bleomycin. Current evidence suggests that reactive oxygen species may play a key role in the development of lung fibrosis. The present work studied the effect of green tea extract on bleomycin–induced lung fibrosis in rats. Animals were divided into three groups: (1) Saline control group; (2) bleomycin group in which rats were injected with bleomycin (15mg/kg,i.p.) three times a week for four weeks; (3) bleomycin and green tea group in which green tea extract was given to rats (100mg/kg/day, p.o) a week prior to bleomycin and daily during bleomycin injections for 4 weeks until the end of the experiment. Bleomycin–induced pulmonary injury and lung fibrosis that was indicated by increased lung hydroxyproline content, elevated nitric oxide synthase, myeoloperoxidase (MPO), platelet activating factor (PAF), tumor necrosis factor α (TNF_α), transforming growth factor 1β (TGF1β) and angiotensin converting enzyme (ACE) activity in lung tissues. On the other hand, bleomycin induced a reduction in reduced glutathione concentration (GSH). Moreover, bleomycin resulted in a severe histological changes in lung tissues revealed as lymphocytes and neutrophils infiltration, increased collagen deposition and fibrosis. Co-administration of bleomycin and green tea extract reduced bleomycin–induced lung injury as evaluated by the significant reduction in hydroxyproline content, nitric oxide synthase activity, levels of MPO, PAF, TNF-α, and ACE in lung tissues. Furthermore, green tea extract ameliorated bleomycin– induced reduction in GSH concentration. Finally, histological evidence supported the ability of green tea extract to attenuate bleomycin–induced lung fibrosis and consolidation. Thus, the finding of the present study provides that green tea may serve as a novel target for potential therapeutic treatment of lung fibrosis.

Keywords: bleomycin, lung fibrosis, green tea, oxygen species

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Authors: Nagore Guerra Bilbao, Clemente Lobato Fraile

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Mentoring is provided by professionals with a higher level of experience and competence as part of the professional development of a university faculty. This paper explores the characteristics of the mentoring provided by those teachers participating in the development of an active methodology program run at the University of the Basque Country: to examine and to analyze mentors’ performance with the aim of providing empirical evidence regarding its value as a lifelong learning strategy for teaching staff. A total of 183 teachers were trained during the first three programs. The analysis method uses a coding technique and is based on flexible, systematic guidelines for gathering and analyzing qualitative data. The results have confirmed the conception of mentoring as a methodological innovation in higher education. In short, university teachers in general assessed the mentoring they received positively, considering it to be a valid, useful strategy in their professional development. They highlighted the methodological expertise of their mentor and underscored how they monitored the learning process of the active method and provided guidance and advice when necessary. Finally, they also drew attention to traits such as availability, personal commitment and flexibility in. However, a minority critique is pointed to some aspects of the performance of some mentors.

Keywords: higher education, mentoring, professional development, university teachers

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Authors: Mahesh Balan U, Rohith Srinivaas Mohanakrishnan, Venkat Subramanian

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Positive and unlabeled learning (PU) has gained more attention in both academic and industry research literature recently because of its relevance to existing business problems today. Yet, there still seems to be some existing challenges in terms of validating the performance of PU learning, as the actual truth of unlabeled data points is still unknown in contrast to a binary classification where we know the truth. In this study, we propose a novel PU learning technique based on the Pseudo-F measure, where we address this research gap. In this approach, we train the PU model to discriminate the probability distribution of the positive and unlabeled in the validation and spy data. The predicted probabilities of the PU model have a two-fold validation – (a) the predicted probabilities of reliable positives and predicted positives should be from the same distribution; (b) the predicted probabilities of predicted positives and predicted unlabeled should be from a different distribution. We experimented with this approach on a credit marketing case study in one of the world’s biggest fintech platforms and found evidence for benchmarking performance and backtested using historical data. This study contributes to the existing literature on semi-supervised learning.

Keywords: PU learning, semi-supervised learning, pseudo f measure, classification

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Authors: Sasha Goodwin

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Sex offenders are often viewed as a homogenous group, but they encompass a diverse range of individuals with varying characteristics and offenses. The principal aim of this study was to ascertain how members of the Australian public perceive and define a sex offender while also investigating the emotional underpinnings associated with these attitudes and definitions. To assess public attitude, this study used the innovative utilization of visual methodologies to assess the public's perception of sex offenders. The study employed the iSquare approach, a visual methodology framework that offers unique viewpoints and insights into public attitudes toward sex offenders. Through the utilization of this approach, this study established an academic foundation for a deeper understanding of the public's perception of sex offenders. The data analysis revealed that most participants associated sex offenders with strong negative emotions, primarily disgust and anger. The findings of this research point towards the potential for fostering a social environment characterized by evidence-based discussions instead of reactionary punitive responses. Promoting a comprehensive understanding of the diverse nature of sexual offenders aims to broaden perceptions, fostering constructive attitudes.

Keywords: visual methodologies, public perception, sex offenders, offender characteristics, emotional attitudes, isquare approach, attitudes

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Authors: Estefanya Vazquez-Casaubon, Veroline Cauberghe, Dieneke Van de Sompel, Hayley Pearce

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Working together to reduce the anthropogenic impact should be a collective action, including effort within the household. In the matter, children are considered to have an important role in influencing the household to reduce the environmental impact through reversed socialization where children motivate and increase the concern of the parents towards environmental protection. Previous studies reveal that communication between parents and kids is key for effective reversed socialization. However, multiple barriers have been identified in the literature, such as the acceptance of the influence from the kids, the properties of the communication, among other factors. Based on the previous evidence, the present study aims to assess barriers and facilitators of communication at the household level that have an impact on reversed socialization. More precisely, the study examines how parents’ climate change coping strategy (problem-focused, meaning-focused, disregarding) influences the valence and the type of the communication related to climate change, and eventually the extent to which they report their beliefs and behaviours to be influenced by the pro-environmental perspectives of their children; i.e. reversed socialization. Via an online survey, 723 Belgian parents self-reported on communication about environmental protection and risk within their household (such as the frequency of exchange about topics related to climate change sourced from school, the household rules, imparting knowledge to the children, and outer factors like media or peer pressure, the emotional valence of the communication), their perceived socialization, and personal factors (coping mechanisms towards climate change). The results, using structural equation modelling, revealed that parents applying a problem-solving coping strategy related to climate change, appear to communicate more often in a positive than in a negative manner. Parents with a disregarding coping style towards climate change appear to communicate less often in a positive way within the household. Parents that cope via meaning-making of climate change showed to communicate less often in either a positive or negative way. Moreover, the perceived valence of the communication (positive or negative) influenced the frequency and type of household communication. Positive emotions increased the frequency of the communication overall. However, the direct effect of neither of the coping mechanisms on the reversed socialization was significant. High frequency of communication about the media, environmental views of the household members among other external topics had a positive impact on the perceived socialization, followed by discussions school-related; while parental instructing had a negative impact on the perceived socialization. Moreover, the frequency of communication was strongly affected by the perceived valence of the communication (positive or negative). The results go in line with previous evidence that a higher frequency of communication facilitates reversed socialization. Hence the results outstand how the coping mechanisms of the parents can be either a facilitator when they cope via problem-solving, while parents that disregard might avert frequent communication about climate change at the household.

Keywords: communication, parents’ coping mechanisms, environmental protection, household, perceived socialization

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