Search results for: confidence interval lengths

Authors: Keyao Li, Sai On Cheung

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Incorporation of alternative dispute resolution (ADR) mechanism has been the main feature of current trend of construction project dispute resolution (CPDR). ADR approaches have been identified as efficient mechanisms and are suitable alternatives to litigation and arbitration. Moreover, the use of ADR in this multi-tiered dispute resolution process often leads to repeated evaluations of a same dispute. Multi-tiered CPDR may become a breeding ground for cognitive biases. When completed knowledge is not available at the early tier of construction dispute resolution, disputing parties may form preconception of the dispute matter or the counterpart. This preconception would influence their information processing in the subsequent tier. Disputing parties tend to search and interpret further information in a self-defensive way to confirm their early positions. Their imbalanced information collection would boost their confidence in the held assessments. Their attitudes would be hardened and difficult to compromise. The occurrence of cognitive bias, therefore, impedes efficient dispute settlement. This study aims to explore ways to minimize bias in CPDR. Based on a comprehensive literature review, three types of bias minimizing approaches were collected: strategy-based, attitude-based and process-based. These approaches were further operationalized into bias minimizing measures. To verify the usefulness and practicability of these bias minimizing measures, semi-structured interviews were conducted with ten CPDR third party neutral professionals. All of the interviewees have at least twenty years of experience in facilitating settlement of construction dispute. The usefulness, as well as the implications of the bias minimizing measures, were validated and suggested by these experts. There are few studies on cognitive bias in construction management in general and in CPDR in particular. This study would be the first of its type to enhance the efficiency of construction dispute resolution by highlighting strategies to minimize the biases therein.

Keywords: bias, construction project dispute resolution, minimization, multi-tiered, semi-structured interview

Procedia PDF Downloads 186

Authors: Yutong Xu, Wanting Zhang, Jia Wang, Zihan Guo, Weiguang Ma

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Background: The resilience education of intern nursing students has significant implications for the development and improvement of the nursing workforce. The clinical internship period is a critical time for enhancing resilience. Aims: To evaluate the resilience level of Chinese nursing interns and identify the factors affecting resilience early in their careers. Methods: The cross-sectional study design was adopted. From March 2022 to May 2023, 512 nursing interns in tertiary care hospitals were surveyed online with the Connor-Davidson Resilience Scale, the Clinical Learning Environment scale for Nurse, and the Career Adapt-Abilities Scale. Structural equation modeling was used to clarify the relationships among these factors. Indirect effects were tested using bootstrapped Confidence Intervals. Results: The nursing interns showed a moderately high level of resilience[M(SD)=70.15(19.90)]. Gender, scholastic attainment, had a scholarship, career adaptability and clinical learning environment were influencing factors of nursing interns’ resilience. Career adaptability and clinical learning environment positively and directly affected their resilience level (β = 0.58, 0.12, respectively, p＜0.01). career adaptability also positively affected career adaptability (β = 0.26, p < 0.01), and played a fully mediating role in the relationship between clinical learning environment and resilience. Conclusion: Career adaptability can enhance the influence of clinical learning environment on resilience. The promotion of career adaptability and the clinical teaching environment should be the potential strategies for nursing interns to improve their resilience, especially for those female nursing interns with low academic performance. Implications for Nursing Educators Nursing educators should pay attention to the cultivation of nursing students' resilience; for example, by helping them integrate to the clinical learning environment and improving their career adaptability. Reporting Method: The STROBE criteria were used to report the results of the observations critically. Patient or Public Contribution No patient or public contribution.

Keywords: resilience, clinical learning environment, career adaptability, nursing interns

Procedia PDF Downloads 89

Authors: Mohammad K. Rumjaun, Sana Amjed, Muhammad A. Ghazi, Safa G. Attar, Jason Raw

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Background: National Health Service (NHS) in England is one of the leading healthcare systems in the world and it heavily relies on the recruitment of overseas doctors. 30.7% of the doctors currently serving in NHS are overseas doctors. Most of these doctors do not receive the essential induction required to work in the NHS when they first arrive and therefore, they mostly struggle to work effectively in the first few months of their new jobs as compared to UK graduates. In our hospital, the clinical need for a dedicated induction programme for the International Medical Graduates (IMGs) was identified for their initial settling period and this programme was designed to achieve this. Methods: A questionnaire was designed for the previous 7 IMGs (Group 1) in order to identify the difficulties they faced in their initial phase. Thereafter, an induction programme consisting of presentations explaining the NHS and hospital framework, communication skills practice sessions, the clinical ceiling of care and patient simulation training was implemented for 6 new IMGs (Group 2). Another survey was done and compared with the previous. Results: After this programme, group 2 required only 1 week to understand the complexity of the IT systems as compared 3 weeks in group 1. 83% of group 2 was well-supported for their on-call duties after this programme as compared to 29% and 100% of group 2 was aware of their role in the job after the induction as compared to 0%. Furthermore, group 2 was able to function independently and confidently in their roles after only 1 month as compared to an average of 3 months for group 1. After running the PDSA cycles, our results show clear evidence that this programme has tremendously benefitted the IMGs in settling in the NHS. The IMGs really appreciated this initiative and have given positive feedback. Conclusion: Leaving your home country to begin your career in a different country is not an easy transition and undoubtedly, everyone struggles. It is important to invest in a well-structured induction programme for the IMGs in the initial phase of their jobs as this will improve not only their confidence and efficacy but also patients’ safety.

Keywords: induction programme, international medical graduates, NHS, overseas doctors struggles.

Procedia PDF Downloads 135

Authors: U.-B. Schaer, M. Wehr, R. Hodler

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Background: Most nursing students require more training time for necessary nursing skills than defined by nursing schools curriculum to acquire basic nursing skills. Given skills training lessons are too brief to enable effective student learning, meaning in-depth skills practice and repetition various learning steps. This increases stress levels and the pressure to succeed for a nursing student with slower learning capabilities. Another possible consequence is that nursing students are less prepared in the required skills for future clinical practice. Intervention: The Bern College of Higher Education of Nursing, Switzerland, started the independent peer practice learning program in 2012. A concept was developed which defines specific aims and content as well as student’s rights and obligations. Students enlist beforehand and order the required materials. They organize themselves and train in small groups in allocated training location in the area of Learning Training and Transfer (LTT). During the peer practice, skills and knowledge can be repeatedly trained and reflected in the peer groups without the presence of a tutor. All invasive skills are practiced only on teaching dummies. This allows students to use all their potential. The students may access learning materials as literature and their own student notes. This allows nursing students to practice their skills and to deepen their knowledge on corresponding with their own learning rate. Results: Peer group discussions during the independent peer practice learning support the students in gaining certainty and confidence in their knowledge and skills. This may improve patient safety in future daily care practice. Descriptive statics show that the number of students who take advantage of the independent peer practice learning increased continuously (2012-2018). It has to be mentioned that in 2012, solely students of the first semester attended the independent peer practice learning program, while in 2018 over one-third of the participating students were in their fifth semester and final study year. It is clearly visible that the demand for independent peer practice learning is increasing. This has to be considered in the development of future teaching curricula.

Keywords: learning program, nursing students, peer learning, skill training

Procedia PDF Downloads 121

Authors: May Khei Hu, Kevin Leong, Fu Siong Ng, Nicholas Peter

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Introduction: Sympathetic stimulation has been recognised as a potent stimulus of arrhythmogenesis in various cardiac pathologies, possibly by augmenting dispersion of repolarisation. The effects of sympathetic stimulation in healthy subjects however remain unclear. It is, therefore, crucial to first establish the effects of physiological stress on dispersion of repolarisation in healthy subjects before understanding these effects in pathological cardiac conditions. We hypothesised that activation-recovery interval (ARI; which is a surrogate of action potential duration) and dispersion of repolarisation decrease on sympathetic stimulation. Methods: Eight patients aged 18-55 years with structurally normal hearts underwent head-up tilt test (HUTT) and exercise tolerance test (ETT) while wearing the electrocardiographic imaging (ECGi) vest. Patients later underwent CT scan and the epicardial potentials are reconstructed using the ECGi software. Activation and recovery times were determined from the acquired electrograms. ARI was calculated and later corrected using Bazett’s formula. Global and regional dispersion of repolarisation were determined from standard deviation of the corrected ARI (ARIc). One-way analysis of variance (ANOVA) and Wilcoxon test were used to evaluate statistical significance. Results: Global ARIc increased significantly [p<0.01] when patients were tilted upwards but decreased significantly after five minutes [p<0.01]. A subsequent post- hoc analysis revealed that the decrease in R-R was more substantial compared to the change in ARI, resulting in the observed increase in ARIc. Global ARIc decreased on peak exercise [p<0.01] but increased on recovery [p<0.01]. Global dispersion increased significantly on peak exercise [p<0.05] although there were no significant changes in regional dispersion. There were no significant changes in both global and regional dispersion during tilt. Conclusion: ARIc decreases upon sympathetic stimulation in healthy subjects. Global dispersion of repolarisation increases upon exercise although there were no changes in global or regional dispersion during orthostatic stress.

Keywords: dispersion of repolarisation, sympathetic stimulation, Head-up tilt test (HUTT), Exercise tolerance test (ETT), Electrocardiographic imaging (ECGi)

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Authors: Basant Singh Sikarwar, Mukesh Roy, Ayush Goyal, Priya Ranjan

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This work combines two bodies of knowledge which includes biomedical basis of blood stain formation and fluid communities’ wisdom that such formation of blood stain depends heavily on physical properties. Moreover biomedical research tells that different patterns in stains of blood are robust indicator of blood donor’s health or lack thereof. Based on these valuable insights an innovative screening tool is proposed which can act as an aide in the diagnosis of diseases such Anemia, Hyperlipidaemia, Tuberculosis, Blood cancer, Leukemia, Malaria etc., with enhanced confidence in the proposed analysis. To realize this powerful technique, simple, robust and low-cost micro-fluidic devices, a micro-capillary viscometer and a pendant drop tensiometer are designed and proposed to be fabricated to measure the viscosity, surface tension and wettability of various blood samples. Once prognosis and diagnosis data has been generated, automated linear and nonlinear classifiers have been applied into the automated reasoning and presentation of results. A support vector machine (SVM) classifies data on a linear fashion. Discriminant analysis and nonlinear embedding’s are coupled with nonlinear manifold detection in data and detected decisions are made accordingly. In this way, physical properties can be used, using linear and non-linear classification techniques, for screening of various diseases in humans and cattle. Experiments are carried out to validate the physical properties measurement devices. This framework can be further developed towards a real life portable disease screening cum diagnostics tool. Small-scale production of screening cum diagnostic devices is proposed to carry out independent test.

Keywords: blood, physical properties, diagnostic, nonlinear, classifier, device, surface tension, viscosity, wettability

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Authors: D. Naranchimeg, G. Ulziisaikhan

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Student dropout problem has not been recently investigated within the Mongolian higher education. A student dropping out is a personal decision, but it may cause unemployment and other social problems including low quality of life because students who are not completed a degree cannot find better-paid jobs. The research aims to determine percentage of at-risk students, and understand reasons for dropouts and to find a way to predict. The study based on the students of the Mongolian National University of Education including its Arkhangai branch school, National University of Mongolia, Mongolian University of Life Sciences, Mongolian University of Science and Technology, Mongolian National University of Medical Science, Ikh Zasag International University, and Dornod University. We conducted the paper survey by method of random sampling and have surveyed about 100 students per university. The margin of error - 4 %, confidence level -90%, and sample size was 846, but we excluded 56 students from this study. Causes for exclusion were missing data on the questionnaire. The survey has totally 17 questions, 4 of which was demographic questions. The survey shows that 1.4% of the students always thought to dropout whereas 61.8% of them thought sometimes. Also, results of the research suggest that students’ dropouts from university do not have relationships with their sex, marital and social status, and peer and faculty climate, whereas it slightly depends on their chosen specialization. Finally, the paper presents the reasons for dropping out provided by the students. The main two reasons for dropouts are personal reasons related with choosing wrong study program, not liking the course they had chosen (50.38%), and financial difficulties (42.66%). These findings reveal the importance of early prevention of dropout where possible, combined with increased attention to high school students in choosing right for them study program, and targeted financial support for those who are at risk.

Keywords: at risk students, dropout, faculty climate, Mongolian universities, peer climate

Procedia PDF Downloads 397

Authors: Yelbek B. Utepov, Assel S. Tulebekova, Alizhan B. Kazkeyev

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Maturity sensors are used to determine concrete strength by the non-destructive method. The method of placement of the maturity sensors determines their number required for a certain frame of a monolithic building. Previous studies weakly describe this aspect, giving only logical assumptions. This paper proposes a cheap prototype of an embedded wireless sensor for monitoring concrete structures, as well as an alternative strategy for placing sensors based on the transitional boundaries of the temperature distribution of concrete curing, which were determined by building a heat map of the temperature distribution, where unknown values are calculated by the method of inverse distance weighing. The developed prototype can simultaneously measure temperature and relative humidity over a smartphone-controlled time interval. It implements a maturity method to assess the in-situ strength of concrete, which is considered an alternative to the traditional shock impulse and compression testing method used in Kazakhstan. The prototype was tested in laboratory and field conditions. The tests were aimed at studying the effect of internal and external temperature and relative humidity on concrete's strength gain. Based on an experimentally poured concrete slab with randomly integrated maturity sensors, it was determined that the transition boundaries form elliptical forms. Temperature distribution over the largest diameter of the ellipses was plotted, resulting in correct and inverted parabolas. As a result, the distance between the closest opposite crossing points of the parabolas is accepted as the maximum permissible step for setting the maturity sensors. The proposed placement strategy can be applied to sensors that measure various continuous phenomena such as relative humidity. Prototype testing has also revealed Bluetooth inconvenience due to weak signal and inability to access multiple prototypes simultaneously. For this reason, further prototype upgrades are planned in future work.

Keywords: heat map, placement strategy, temperature and relative humidity, wireless embedded sensor

Procedia PDF Downloads 177

Authors: Omneya Messallam

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Technology has been developed dramatically in most of the educational disciplines. For instance, digital rendering subject, which is being taught in both Interior and Architecture fields, is witnessing almost annually updated software versions. A lot of students and educators argued that there will be no need for manual rendering techniques to be learned. Therefore, the Interior Design Visual Presentation 1 course (ID133) has been chosen from the first level of the Interior Design (ID) undergraduate program, as it has been taught for six years continually. This time frame will facilitate sound observation and critical analysis of the use of appropriate teaching methodologies. Furthermore, the researcher believes in the high value of the manual rendering techniques. The course objectives are: to define the basic visual rendering principles, to recall theories and uses of various types of colours and hatches, to raise the learners’ awareness of the value of studying manual render techniques, and to prepare them to present their work professionally. The students are female Arab learners aged between 17 and 20. At the outset of the course, the majority of them demonstrated negative attitude, lacking both motivation and confidence in manual rendering skills. This paper is a reflective appraisal of deploying two student-centred teaching pedagogies which are: Project-based learning (PBL) and Outcome-based education (OBE) on ID133 students. This research aims of developing some teaching strategies to enhance the quality of teaching in this given course over an academic semester. The outcome of this research emphasized the positive influence of applying such educational methods on improving the quality of students’ manual rendering skills in terms of: materials, textiles, textures, lighting, and shade and shadow. Furthermore, it greatly motivated the students and raised the awareness of the importance of learning the manual rendering techniques.

Keywords: project-based learning, outcome-based education, visual presentation, manual render, personal competences

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Authors: Mahani Razali, Nordin Mamat

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The purpose of this research is to identify the teacher’s role and parent’s participation to develop children`s socio emotion through play activities. This research is based on three main objectives which are to identify children`s socio emotion during play activities, teacher’s role and parent’s participation to develop children`s socio emotion. This qualitative study was carried out among 25 pre-school children, three teachers and three parents as the research sample. On the other hand, parent’s support was obtained from their discussions, supervisions and communication at home. The data collection procedures involved structured observation which was to identify socio emotional development element among pre-school children through play activities; as for semi-structured interviews, it was done to study the perception of the teachers and parents on the acquired socio emotional development among the children. Besides, documentation analysis method was used as to triangulate acquired information with observations and interviews. In this study, the qualitative data analysis was tabulated in descriptive manner with frequency and percentage format. This study primarily focused on five main socio emotional elements among the pre-school children: 1) Cooperation, 2) Confidence and Courage, 3) Ability to communicate, 4) patience, and 5) Tolerance. The findings of this study were presented in the form of case to case manner from the researches sample. Findings revealed that the children showed positive outcomes on the socio emotional development during their play. Both teachers and parents showed positive perceptions towards the acquired socio emotional development during their play activities. In conclusion, this research summarizes that teacher’s role and parent’s support can improve children`s socio emotional development through play activities. As a whole, this research highlighted the significance of play activities as to stimulate socio emotional development among the pre-school children.

Keywords: social emotional, children, play activities, stimulating

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Authors: Paul Lam, Kevin Wong, Chi Him Chan

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Constant practicing and accurate, immediate feedback are the keys to improving students’ speaking skills. However, traditional oral examination often fails to provide such opportunities to students. The traditional, face-to-face oral assessment is often time consuming – attending the oral needs of one student often leads to the negligence of others. Hence, teachers can only provide limited opportunities and feedback to students. Moreover, students’ incentive to practice is also reduced by their anxiety and shyness in speaking the new language. A mobile app was developed to use artificial intelligence (AI) to provide immediate feedback to students’ speaking performance as an attempt to solve the above-mentioned problems. Firstly, it was thought that online exercises would greatly increase the learning opportunities of students as they can now practice more without the needs of teachers’ presence. Secondly, the automatic feedback provided by the AI would enhance students’ motivation to practice as there is an instant evaluation of their performance. Lastly, students should feel less anxious and shy compared to directly practicing oral in front of teachers. Technically, the program made use of speech-to-text functions to generate feedback to students. To be specific, the software analyzes students’ oral input through certain speech-to-text AI engine and then cleans up the results further to the point that can be compared with the targeted text. The mobile app has invited English teachers for the pilot use and asked for their feedback. Preliminary trials indicated that the approach has limitations. Many of the users’ pronunciation were automatically corrected by the speech recognition function as wise guessing is already integrated into many of such systems. Nevertheless, teachers have confidence that the app can be further improved for accuracy. It has the potential to significantly improve oral drilling by giving students more chances to practice. Moreover, they believe that the success of this mobile app confirms the potential to extend the AI-assisted assessment to other language skills, such as writing, reading, and listening.

Keywords: artificial Intelligence, mobile learning, oral assessment, oral practice, speech-to-text function

Procedia PDF Downloads 103

Authors: Xiaobin Liang, Wei Liang, Laibin Zhang, Xiaoyan Guo

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Pipelines pass through coal mined gobs inevitably in the mining area, the stability of which has great influence on the safety of pipelines. After extensive literature study and field research, it was found that there are a few risk assessment methods for coal mined gob pipelines, and there is a lack of data on the gob sites. Therefore, the fuzzy comprehensive evaluation method is widely used based on expert opinions. However, the subjective opinions or lack of experience of individual experts may lead to inaccurate evaluation results. Hence the accuracy of the results needs to be further improved. This paper presents a comprehensive approach to achieve this purpose by combining bow-tie model and cloud inference. The specific evaluation process is as follows: First, a bow-tie model composed of a fault tree and an event tree is established to graphically illustrate the probability and consequence indicators of pipeline failure. Second, the interval estimation method can be scored in the form of intervals to improve the accuracy of the results, and the censored mean algorithm is used to remove the maximum and minimum values of the score to improve the stability of the results. The golden section method is used to determine the weight of the indicators and reduce the subjectivity of index weights. Third, the failure probability and failure consequence scores of the pipeline are converted into three numerical features by using cloud inference. The cloud inference can better describe the ambiguity and volatility of the results which can better describe the volatility of the risk level. Finally, the cloud drop graphs of failure probability and failure consequences can be expressed, which intuitively and accurately illustrate the ambiguity and randomness of the results. A case study of a coal mine gob pipeline carrying natural gas has been investigated to validate the utility of the proposed method. The evaluation results of this case show that the probability of failure of the pipeline is very low, the consequences of failure are more serious, which is consistent with the reality.

Keywords: bow-tie model, natural gas pipeline, coal mine gob, cloud inference

Procedia PDF Downloads 250

Authors: Mahdi PourAsghar, Abbas Mas'udzadeh, Abdulhakim Tirgari, Saeed Dabiri Roushan, Hooman Rashidi, Fariba Salehi

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Objective: One of the major objectives in sports areas is to achieve maximum athletic performance. Physical and psychological preparations are the basic factors for achieving maximum performance in athletes. Unfortunately, in the field of physical preparation, we can see maximum attention and planning of trainers and sports officials. But despite the importance of psychological preparation of athletes and its serious and profound effect on athletic performance, the results of sports competitions show that less attention is paid to this topic, and it is less under the control of counselors and psychologists in different areas of our sport. Therefore, this study aimed to evaluate the attitude of athletes and coaches to sport psychology. Materials and methods: A descriptive study with a sample size of 234 elite athletes and 216 skilled coaches was conducted in different areas of sports, in Sari, Mazandaran in 2015.The instrument was a questionnaire consisting of two parts of demographic data and Martin questionnaire, assessing the attitude to sport psychology. The data from this study were analyzed using Spss version 18, descriptive statistics tests, and Chi-square test. Results: In this study, positive attitudes of participants in need and confidence towards sport psychology consultation in athletes and coaches group were 55/1 and 56/5 percent, respectively. The positive attitude of female athletes in belief to psychology consultation was more than male athletes. Athletes with higher education had more positive attitude towards the presence of psychologists and psychiatrists in fields of sports. Conclusion: According to the findings based on the need to the psychology consultation in different areas of sports, it is recommended that through training of specialists in the field of sport psychology and review of sports programs in different fields of sports, the presence of these counselors to maintain the psychological preparation of athletes to achieve maximum athletic performance and reduce anxiety and stress be used.

Keywords: Keywords: Athletes, Eliteathletes, Coaches, Attitude, Sport psychology.

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Authors: Lan Luo, Jingjing Huang, Huafang Li

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Introduction: Distressing low sexual desire is common in China, while the lack of reliable and valid instruments to evaluate symptoms of hypoactive sexual desire disorder (HSDD) impedes related research and clinical services. Aim: This study aimed to validate the reliability and validity of the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale-Desire/Arousal/Orgasm (FSDS-DAO) in Chinese female HSDD patients. Methods: We administered FSFI and FSDS-DAO in a convenient sample of Chinese adult women. Participants were diagnosed by a psychiatrist according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR). Results: We had a valid analysis sample of 279 Chinese women, of which 107 were HSDD patients. The Cronbach's α of FSFI and FSDS-DAO were 0.947 and 0.956, respectively, and the intraclass correlation coefficients of which were 0.86 and 0.89, respectively (the interval was 13-15 days). The correlation coefficient between the Revised Adult Attachment Scale (RAAS) and FSFI (or FSDS-DAO) did not exceed 0.4; the area under the receiver operating characteristic (ROC) curve was 0. 83 when combined FSFI-d (the desire domain of FSFI) and FSDS-DAO to diagnose HSDD, which was significantly different from that of using these scales individually. FSFI-d of less than 2.7 (1.2-6) and FSDS-DAO of no less than 15 (0-60) (Sensitivity 65%, Specificity 83%), or FSFI-d of no more than 3.0 (1.2-6) and FSDS-DAO of no less than 14 (0-60) (Sensitivity 74%, Specificity 77%) can be used as cutoff scores in clinical research or outpatient screening. Clinical implications: FSFI (including FSFI-d) and FSDS-DAO are suitable for the screening and evaluation of Chinese female HSDD patients of childbearing age. Strengths and limitations: Strengths include a thorough validation of FSFI and FSDS-DAO and the exploration of the cutoff score combing FSFI-d and FSDS-DAO. Limitations include a small convenience sample and the requirement of being sexually active for HSDD patients. Conclusion: FSFI (including FSFI-d) and FSDS-DAO have good internal consistency, test-retest reliability, construct validity, and criterion validity in Chinese female HSDD patients of childbearing age.

Keywords: sexual desire, sexual distress, hypoactive sexual desire disorder, scale

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Authors: Moshmi Sangavarapu

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The US healthcare industry has undergone tremendous digital transformation in recent years, but critical care access to lower-income ethnicities is still in its nascency. This population has historically showcased substantial hesitation to seek any medical assistance. While the lack of sufficient financial resources plays a critical role, the existing cultural and knowledge barriers also contribute significantly to widening the access gap. It is imperative to break these barriers to ensure timely access to therapeutic procedures that can save important lives! Based on ongoing research, healthcare access barriers can be best addressed by tapping the untapped potential of caregiver communities first. They play a critical role in patients’ diagnoses, building healthcare knowledge and instilling confidence in required therapeutic procedures. Recent technological advancements have opened many avenues by developing smart ways of reaching the large caregiver community. A digitized go-to-market strategy featuring connected media coupled with smart IoT devices and geo-location targeting can be collectively leveraged to reach this key audience group. AI/ML algorithms can be thoroughly trained to identify relevant data signals from users' location and browsing behavior and determine useful marketing touchpoints. The web behavior can be further assimilated with natural language processing to identify contextually relevant interest topics and decipher potential caregivers on digital avenues to serve that brand message. In conclusion, grasping the true health access journey of any lower-income ethnic group is important to design beneficial touchpoints that can alleviate patients’ concerns and allow them to break their own access barriers and opt for timely and quality healthcare.

Keywords: healthcare access, market access, diversity barriers, patient journey

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Authors: Heba Salem

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This paper aims to share the researcher’s experience of using e-Portfolios as an assessment tool to follow up on students’ learning experiences and performance throughout the semester. It also aims at highlighting the importance of students’ self-reflection in the process of language learning. The paper begins by introducing the advanced media course, with its focus on listening and speaking skills, and introduces the students’ profiles. Then it explains the students’ role in the e-portfolio process as they are given the option to choose a listening text they studied throughout the semester and to choose a recorded oral production of their collection of artifacts throughout the semester. Students showcase and reflect on their progress in both listening comprehension and speaking. According to the research, re-listening to work given to them and to their production is a means of reflecting on both their progress and achievement. And choosing the work students want to showcase is a means to promote independent learning as well as self-expression. Students are encouraged to go back to the class learning outcomes in the process of choosing the work. In their reflections, students express how they met the specific learning outcome. While giving their presentations, students expressed how useful the experience of returning and going over what they covered to select one and going over their production as well. They also expressed how beneficial it was to listen to themselves and literally see their progress in both listening comprehension and speaking. Students also reported that they grasped more details from the texts than they did when first having it as an assignment, which coincided with one of the class learning outcomes. They also expressed the fact that they had more confidence speaking as well as they were able to use a variety of vocabulary and idiomatic expressions that students have accumulated. For illustration, this paper includes practical samples of students’ tasks and instructions as well as samples of their reflections. The results of students’ reflections coincide with what the research confirms about the effectiveness of the e-portfolios as a means of assessment. The employment of e-Portfolios has two-folded benefits; students are able to measure the achievement of the targeted learning outcomes, and teachers receive constructive feedback on their teaching methods.

Keywords: e-portfolios, assessment, self assessment, listening and speaking progress, foreign language, reflection, learning out comes, sharing experience

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Authors: Peeranan Wisanskoonwong, Sumitta Sawangtook

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Practicum in Midwifery II is the subject that affects most students to be stressed and anxious because they lack of experiences and self-confidence in delivery baby. This study is a qualitative research. That research objectives were (1) to study learning through reflective practice of nursing students (2) to explain the effects of learning through reflective practice of nursing students in the delivery room. The selected key informant method was criterion-based selection. Thirty-two of fourth-year nursing students in Kuakarun Faculty of nursing who practiced in Delivery room at Taksin Hospital in academic year 2014 were selected. Data collection was data triangulation which consisted of in-depth interview, group discussion and reading students’ reflective practice journal. The research instruments were students’ reflective practice journal, semi-structured questionnaires for in-depth interview, group discussion. Data analysis was thematic analysis. The research result found that: The learning method through reflective practice of nursing students in the delivery room were (1) reflective practice journal (2) dialogue (3) critical thinking and problem solving (4) incident analysis (5) self-criticism (6) observation and evaluation of practice. There were eight issues that students learned through their reflective practice were that (1) students' ethics and morality. (2) students' knowledge and comprehension (3) creative thinking of students (4) communications and collaboration (5) experiential learning of students (6) students’memories and impressions (7) students’experience in delivery baby (8) self-learning of students. Learning through reflective practice supported students’ awareness in improving knowledge and learning continuously and systematically. It helped to adjust the attitude to learning and leadership to be careful which help develop their skills, including critical thinking and understand themselves and understand others. Recommendation for applying research results: midwifery and nursing lecturers can apply these results to be a guide for development their clinical teaching in delivery rooms and other wards.

Keywords: learning, reflection, birth, qualitative research

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Authors: Shadreck Muchaku, Grey Magaiza, Jerit Dube

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The high insolvency rate of female-led emerging enterprises in the Southern African mountain region reflects the various vulnerabilities that exist. Although this is the case, there is a limited understanding of how these vulnerabilities influence entrepreneurship failure. This paper focuses on female entrepreneurs because of their role in economic development. Emerging female entrepreneurs in this region often operate in uncertain environments, which makes it difficult for them to thrive. The form and nature of entrepreneurial opportunities rural women of the Afro Montane region engage in are largely unsustainable as a lot of women struggle with confidence, and they need help with understanding their skills. However, there is still a gap in the existing literature on women entrepreneurship resilience and vulnerability reduction in the Afromontane. Furthermore, a major problem is the lack of empirical studies on this matter and limited studies indicating a general profile of emerging female entrepreneurs in this region. This systematic literature review attempts to fill in the gap of knowledge on entrepreneurship resilience and vulnerability reduction of emerging female entrepreneurs in the Afromontane regions and other similar precarious environments. In this review, we focus much on highlighting the nexus between entrepreneurship resilience and vulnerability reduction of emerging female entrepreneurs in academic literature through a chronological dispersal of publications in developing countries. This review adopts an ATLAS ti.22 software-based thematic analysis to analyze results obtained from reviewed academic journal articles. As research on entrepreneurship resilience and vulnerability reduction is still developing in the Sothern African mountain region, the results of this review will contribute to the body of literature and provide recommendations and a foundation for future research. This systematic review paper provides valuable insights and methodological approaches to scholarship in a nascent area of emerging female entrepreneurs in the Afromontane.

Keywords: entrepreneurship resiliency, vulnerability reduction, female entrepreneurs, mountain regions

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Authors: Ekaterina Malova

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Type 1 diabetes (T1D) is a chronic illness requiring immense lifestyle changes to reduce the chance of life-threatening complications. Moving to a college may be the first time for a young adult with T1D to take responsibility for all the aspects of their diabetes care. In addition, people with T1D constantly face stigmatization and discrimination as a result of their health condition, which puts additional pressure on young adults with T1D. Hence, omissions in diabetes self-care often occur during the time of transition to college when both the social and physical environment of young adults changes drastically and contribute to the fact that emerging young adults remain one of the age groups with the highest hemoglobin levels and poorest diabetes control. However, despite potential severe health risks caused by a lack of proper diabetes self-care, little is known about the experiences of emerging adults embarking on a higher education journey as this population. Thus, young adults with type 1 diabetes are a 'forgotten group,' meaning that their experiences are rarely addressed by researchers. Given that self-disclosure and information-seeking can be challenging for individuals with stigmatized illnesses, online platforms like YouTube have become a popular medium of self-disclosure and information-seeking for people living with T1D. Thus, this study aims to provide an analysis of experiences that college students with T1D choose to share with the general public online and explore the nature of information being communicated by college students with T1D to the online community in personal narratives posted on YouTube. A systematic approach was used to retrieve a video sample by searching YouTube with keywords 'type 1 diabetes' and 'college,' with results ordered by relevance. A total of 18 videos were saved. Video lengths ranged from 2 to 28 minutes. The data were coded using NVivo. Video transcripts were coded and analyzed utilizing the thematic analysis method. Three key themes emerged from thematic analysis: 1) Advice, 2) Personal experience, and 3) Things I wish everyone knew about T1D. In addition, Theme 1 was divided into subtopics to differentiate between the most common types of advice: 1) Overcoming stigma and b) Seeking social support. The identified themes indicate that two groups of the population can potentially benefit from watching students’ video testimonies: 1) lay public and 2) other students with T1D. Given that students in the videos reported a lack of T1D education in the lay public, such video narratives can serve important educational purposes and reduce health stigma, while perceived similarity and identification with students in the videos may facilitate the transition of health information to other individuals with T1D and positively affect their diabetes routine. Thus, online video narratives can potentially serve both educational and persuasive purposes, empowering students with T1D to stay in control of T1D while succeeding academically.

Keywords: type 1 diabetes, college students, health communication, transition period

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Authors: Thais Cardoso Franco, Caio Nahuel Sousa Fagonde, Willer Gomes dos Santos

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Aurora Borealis is an optical phenomenon composed of luminous events observed in the night skies in the polar regions resulting from disturbances in the magnetosphere due to the impact of solar wind particles with the Earth's upper atmosphere, channeled by the Earth's magnetic field, which causes atmospheric molecules to become excited and emit electromagnetic spectrum, leading to the display of lights in the sky. However, there are still different implications of this phenomenon under study: high intensity auroras are often accompanied by geomagnetic storms that cause blackouts on Earth and impair the transmission of signals from the Global Navigation Satellite Systems (GNSS). Auroras are also known to occur on other planets and exoplanets, so the activity is an indication of active space weather conditions that can aid in learning about the planetary environment. In order to improve understanding of the phenomenon, this research aims to design a satellite formation flying solution for collecting and transmitting data for monitoring aurora borealis in northern hemisphere, an approach that allows studying the event with multipoint data collection in a reduced time interval, in order to allow analysis from the beginning of the phenomenon until its decline. To this end, the ideal number of satellites, the spacing between them, as well as the ideal topology to be used will be analyzed. From an orbital study, approaches from different altitudes, eccentricities and inclinations will also be considered. Given that at large relative distances between satellites in formation, controllers tend to fail, a study on the efficiency of nonlinear adaptive control methods from the point of view of position maintenance and propellant consumption will be carried out. The main orbital perturbations considered in the simulation: non-homogeneity terrestrial, atmospheric drag, gravitational action of the Sun and the Moon, accelerations due to solar radiation pressure and relativistic effects.

Keywords: formation flying, nonlinear adaptive control method, aurora borealis, adaptive SDRE method

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Authors: Nazish Badar

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Background: To investigate the epidemic resurgent wave of influenza A (H1N1) pdm09 infections during 2015-16 Influenza season(Nov,15 –Feb,16) we compared epidemiological features of influenza A (H1N1) pdm09 associated hospitalizations and deaths during this period in Pakistan. Methods: Respiratory samples were tested using CDC Real-Time RT-PCR protocols. Demographic and epidemiological data was analyzed using SPSS. Risk ratio was calculated between age groups to compare patients that were hospitalized and died due to influenza A (H1N1) pdm09 during this period. Results: A total of 1970 specimens were analyzed; influenza virus was detected in 494(25%) samples, including 458(93%) Influenza type A and 36(7%) influenza type B viruses. Amongst influenza A viruses, 351(77%) A(H1N1) pdm09 and 107(23%) were A/H3N2. Influenza A(H1N1)pdm09 peaked in January 2016 when 250(54%) of tested patients were positive. The resurgent waves increased hospitalizations due to pdmH1N1 as compared to the rest part of the year. Overall 267(76%) A(H1N1) pdm09 cases were hospitalized. Adults ≥18 years showed the highest relative risk of hospitalization (1.2). Median interval of hospitalization and symptom onset was five days for all age groups. During this period, a total of 34 laboratory-confirmed deaths associated with pandemic influenza A (H1N1) were reported out of 1970 cases, the case fatality rate was 1.72%. the male to female ratio was 2:1in reported deaths. The majority of the deaths during that period occurred in adults ≥18 years of age. Overall median age of the death cases was 42.8 years with underlying medical conditions. The median number of days between symptom onset was two days. The diagnosis upon admission in influenza-associated fatal cases was pneumonia (53%). Acute Respiratory Distress Syndrome 9 (26%), eight out of which (88%) required mechanical ventilation. Conclusions: The present resurgence of pandemic virus cannot be attributed to a single factor. The prolong cold and dry weather, possibility of drift in virus and absence of annual flu vaccination may have played an integrated role in resurfacing of pandemic virus.

Keywords: influenza A (H1N1)pdm 09, resurgence, epidemiology, Pakistan

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Authors: Edwina Owusu Panin, Kwame Baah Owusu Panin

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This abstract intends to demonstrate multiple strategies of autism management in Ghana by exploring the possibilities. The advantages of adopting creative art forms as a therapeutic method. Autism is a developmental disorder that includes social interaction, communication, and repetitive behaviours. In Ghana, as in many other countries, there is a rising demand for effective intervention and support for people with autism and their families. Creative arts such as music, dance, drama and visual arts have shown promise in promoting communication, social interaction and inclusion of people with autism. These art forms provide alternative channels for self-expression and can be powerful tools for autistic people to interact with the world, their friends and families around them. Creative art forms interventions have been found to improve social skills, improve emotion regulation, promote creativity and increase self-confidence in people with autism. This study examines existing programs and interventions in Ghana involving creative art forms for people with autism through a comparative analysis. It explores the different approaches, methods and results of these interventions. By comparing and evaluating these programs, the study aims to identify best practices, challenges and areas for development in managing autism through the creative arts in Ghana. Although many schools and rehabilitation centres employ various forms in therapeutic approaches for autism. There is no comparative analysis of which type of autism and which creative art forms is suitable. The results of this study will contribute to the development of evidence-based practices for the management of autism in Ghana. It provides valuable information about the effectiveness of creative arts interventions and helps inform policy makers, educators, therapists and other stakeholders involved in autism support. Ultimately, the goal is to improve the well-being and quality of life of people with autism in Ghana and their families by promoting inclusive and accessible interventions that harness the power of creative art forms.

Keywords: autism, therapeutic, creative art, art form

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Authors: Panrapee Suttiwan, Rewadee Watakakosol Arunya Tuicomepee, Sakkaphat T. Ngamake

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Alcohol consumption ranks among the top six of health-risk behaviors that lead to disability and death among Thai teenagers. Underage drinkers have higher health risks than their non-drinking peers do. This study, therefore, aimed to explore salient beliefs of Thai teenagers with alcohol reduction and cessation based on the Theory of Planned Behaviour theoretical framework. Participants were 225 high-school and vocational school students, most of whom (60.9%) consumed alcohol almost daily (5-6 times / week), and one-third of whom (33.8%) reported habitual moderate drink. The average age was 16.5 (SD = 0.9), and the average age of the first use of alcohol was 13.7 (SD = 2.2). Instrument was an open-ended questionnaire that elicited beliefs about having alcohol reduction / cessation in the past 12 months. Findings revealed salient benefit beliefs of alcohol reduction / cessation among the teens such as improved physical and mental health, accident and violence avoidance, less sexual risks, money and time saving, better academic performance, and improved relationships. In contrast, the teens identified several disadvantage beliefs such as deteriorating health, social awkwardness, lack of little fun, excitement, and experience, physical uneasiness, stress, and lack of self-confidence. Salient normative groups for alcohol reduction / cessation included parents, elder relatives, siblings, close friends, teachers, boy / girlfriends, and seniors / juniors at school. Situations influencing alcohol reduction / cessation included quarrels with boy / girlfriends, family conflicts, peer pressure, partying and socializing, festive holidays and anniversary celebration, and visiting entertainment places, etc. This study provides empirical evidence that help to identify normative attitudes towards alcohol reduction / cessation and may thus be an important knowledge for public health campaigns seeking to reduce alcohol consumption in this population.

Keywords: alcohol consumption reduction, cessation, salient belief, Thai teenagers

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Authors: Jérôme de Reffye, Marc Antoni

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Following the development of the ERTMS system, we think it is interesting to develop another software-based track circuit system which would fit secondary railway lines with an easy-to-work implementation and a low sensitivity to rail-wheel impedance variations. We called this track circuit 'Track Railway by Automatic Circuits.' To be internationally implemented, this system must not have any mechanical component and must be compatible with existing track circuit systems. For example, the system is independent from the French 'Joints Isolants Collés' that isolate track sections from one another, and it is equally independent from component used in Germany called 'Counting Axles,' in French 'compteur d’essieux.' This track circuit is fully interoperable. Such universality is obtained by replacing the train detection mechanical system with a space-time filtering of train position. The various track sections are defined by the frequency of a continuous signal. The set of frequencies related to the track sections is a set of orthogonal functions in a Hilbert Space. Thus the failure probability of track sections separation is precisely calculated on the basis of signal-to-noise ratio. SNR is a function of the level of traction current conducted by rails. This is the reason why we developed a very powerful algorithm to reject noise and jamming to obtain an SNR compatible with the precision required for the track circuit and SIL 4 level. The SIL 4 level is thus reachable by an adjustment of the set of orthogonal functions. Our major contributions to railway engineering signalling science are i) Train space localization is precisely defined by a calibration system. The operation bypasses the GSM-R radio system of the ERTMS system. Moreover, the track circuit is naturally protected against radio-type jammers. After the calibration operation, the track circuit is autonomous. ii) A mathematical topology adapted to train space localization by following the train through a linear time filtering of the received signal. Track sections are numerically defined and can be modified with a software update. The system was numerically simulated, and results were beyond our expectations. We achieved a precision of one meter. Rail-ground and rail-wheel impedance sensitivity analysis gave excellent results. Results are now complete and ready to be published. This work was initialised as a research project of the French Railways developed by the Pi-Ramses Company under SNCF contract and required five years to obtain the results. This track circuit is already at Level 3 of the ERTMS system, and it will be much cheaper to implement and to work. The traffic regulation is based on variable length track sections. As the traffic growths, the maximum speed is reduced, and the track section lengths are decreasing. It is possible if the elementary track section is correctly defined for the minimum speed and if every track section is able to emit with variable frequencies.

Keywords: track section, track circuits, space-time crossing, adaptive track section, automatic railway signalling

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Authors: Marcel Meinhardt, Manfred Keuser, Thomas Braml

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Cracking of reinforced concrete is a complex phenomenon induced by direct loads or restraints affecting reinforced concrete structures as soon as the tensile strength of the concrete is exceeded. Hence it is important to predict where cracks will be located and how they will propagate. The bond theory and the crack formulas in the actual design codes, for example, DIN EN 1992-1-1, are all based on the assumption that the reinforcement bars are embedded in homogeneous concrete without taking into account the influence of transverse reinforcement and the real stress situation. However, it can often be observed that real structures such as walls, slabs or beams show a crack spacing that is orientated to the transverse reinforcement bars or to the stirrups. In most Finite Element Analysis studies, the smeared crack approach is used for crack prediction. The disadvantage of this model is that the typical strain localization of a crack on element level can’t be seen. The crack propagation in concrete is a discontinuous process characterized by different factors such as the initial random distribution of defects or the scatter of material properties. Such behavior presupposes the elaboration of adequate models and methods of simulation because traditional mechanical approaches deal mainly with average material parameters. This paper concerned with the modelling of the initiation and the propagation of cracks in reinforced concrete structures considering the influence of transverse reinforcement and the real stress distribution in reinforced concrete (R/C) beams/plates in bending action. Therefore, a parameter study was carried out to investigate: (I) the influence of the transversal reinforcement to the stress distribution in concrete in bending mode and (II) the crack initiation in dependence of the diameter and distance of the transversal reinforcement to each other. The numerical investigations on the crack initiation and propagation were carried out with a 2D reinforced concrete structure subjected to quasi static loading and given boundary conditions. To model the uncertainty in the tensile strength of concrete in the Finite Element Analysis correlated normally and lognormally distributed random filed with different correlation lengths were generated. The paper also presents and discuss different methods to generate random fields, e.g. the Covariance Matrix Decomposition Method. For all computations, a plastic constitutive law with softening was used to model the crack initiation and the damage of the concrete in tension. It was found that the distributions of crack spacing and crack widths are highly dependent of the used random field. These distributions are validated to experimental studies on R/C panels which were carried out at the Laboratory for Structural Engineering at the University of the German Armed Forces in Munich. Also, a recommendation for parameters of the random field for realistic modelling the uncertainty of the tensile strength is given. The aim of this research was to show a method in which the localization of strains and cracks as well as the influence of transverse reinforcement on the crack initiation and propagation in Finite Element Analysis can be seen.

Keywords: crack initiation, crack modelling, crack propagation, cracks, numerical simulation, random fields, reinforced concrete, stochastic

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Authors: Balasooriya B. M. C. M., Sujeeva N., Thowfeek Z., Siddiqa Omo, Liyanagunawardana J. E., Jayawardana Saiu, Manathunga S. S., Katulanda G. W.

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Introduction and objectives: Adrenal venous sampling (AVS) is the gold standard to discriminate unilateral primary aldosteronism (UPA) from bilateral disease (BPA). AVS is technically demanding and only performed in a limited number of centers worldwide. To the best of our knowledge, Except for one study conducted in India, no other research studies on this area have been conducted in South Asia. This study aimed to evaluate the effectiveness of AVS in the management of primary aldosteronism. Methods: A total of 32 patients who underwent AVS at the National Hospital of Sri Lanka from April 2021 to April 2023 were enrolled. Demographic, clinical and laboratory data were obtained retrospectively. A procedure was considered successful when adequate cannulation of both adrenal veins was demonstrated. Cortisol gradient across the adrenal vein (AV) and the peripheral vein was used to establish the success of venous cannulation. Lateralization was determined by the aldosterone gradient between the two sides. Continuous and categorical variables were summarized with mean, SD, and proportions, respectively. The mean and standard deviation of the contralateral suppression index (CSI) were estimated with an intercept-only Bayesian inference model. Results: Of the 32 patients, the average age was 52.47 +26.14 and 19 (59.4%) were males. Both AVs were successfully cannulated in 12 (37.5%). Among them, lateralization was demonstrated in 11(91.7%), and one was diagnosed as a bilateral disease. There were no total failures. Right AV cannulation was unsuccessful in 18 (56.25%), of which lateralization was demonstrated in 9 (50%), and others were inconclusive. Left AV cannulation was unsuccessful only in 2 (6.25%); one was lateralized, and the other remained inconclusive. The estimated mean of the CSI was 0.33 (89% credible interval 0.11-0.86). Seven patients underwent unilateral adrenalectomy and demonstrated significant improvement in blood pressure during follow-up. Two patients await surgery. Others were treated medically. Conclusions: Despite failure due to procedural difficulties, AVS remained useful in the management of patients with PA. Moreover, the success of the procedure needs experienced hands and advanced equipment to achieve optimal outcomes in PA.

Keywords: adrenal venous sampling, lateralization, contralateral suppression index, primary aldosteronism

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Authors: Sundus Mona, Atif Adnan, Babar Ali, Fareeha Arshad, Allah Rakha

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Molecular diversity is the variation in the abundance of species. Forensic entomology is a neglected field in Pakistan. Insects collected from the crime scene should be handled by forensic entomologists who are currently virtually non-existent in Pakistan. Correct identification of insect specimen along with knowledge of their biodiversity can aid in solving many problems related to complicated forensic cases. Inadequate morphological identification and insufficient thermal biological studies limit the entomological utility in Forensic Medicine. Recently molecular identification of entomological evidence has gained attention globally. DNA barcoding is the latest and established method for species identification. Only proper identification can provide a precise estimation of postmortem intervals. Arthropods are known to be the first tourists scavenging on decomposing dead matter. The objective of the proposed study was to identify species by molecular techniques and analyze their phylogenetic importance with barcoded necrophagous insect species of early succession on human cadavers. Based upon this identification, the study outcomes will be the utilization of established DNA bar codes to identify carrion feeding insect species for concordant estimation of post mortem interval. A molecular identification method involving sequencing of a 658bp ‘barcode’ fragment of the mitochondrial cytochrome oxidase subunit 1 (CO1) gene from collected specimens of unknown dipteral species from cadavers of Lahore was evaluated. Nucleotide sequence divergences were calculated using MEGA 7 and Arlequin, and a neighbor-joining phylogenetic tree was generated. Three species were identified, Chrysomya megacephala, Chrysomya saffranea, and Chrysomya rufifacies with low genetic diversity. The fixation index was 0.83992 that suggests a need for further studies to identify and classify forensically relevant insects in Pakistan. There is an exigency demand for further research especially when immature forms of arthropods are recovered from the crime scene.

Keywords: molecular diversity, DNA barcoding, species identification, forensically relevant

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Authors: Elena Carcano, Mirzi Betasolo

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This study helps Public Water Bureaus in giving reliable answers to water concession requests. Rapidly increasing water requests can be supported provided that further uses of a river course are not totally compromised, and environmental features are protected as well. Strictly speaking, a water concession can be considered a continuous drawing from the source and causes a mean annual streamflow reduction. Therefore, deciding if a water concession is appropriate or inappropriate seems to be easily solved by comparing the generic demand to the mean annual streamflow value at disposal. Still, the immediate shortcoming for such a comparison is that streamflow data are information available only for few catchments and, most often, limited to specific sites. Subsequently, comparing the generic water demand to mean daily discharge is indeed far from being completely satisfactory since the mean daily streamflow is greater than the water withdrawal for a long period of a year. Consequently, such a comparison appears to be of little significance in order to preserve the quality and the quantity of the river. In order to overcome such a limit, this study aims to complete the information provided by flow duration curves introducing a link between Flow Duration Curves (FDCs) and recession curves and aims to show the chronological sequence of flows with a particular focus on low flow data. The analysis is carried out on 25 catchments located in North-Eastern Italy for which daily data are provided. The results identify groups of catchments as hydrologically homogeneous, having the lower part of the FDCs (corresponding streamflow interval is streamflow Q between 300 and 335, namely: Q(300), Q(335)) smoothly reproduced by a common recession curve. In conclusion, the results are useful to provide more reliable answers to water request, especially for those catchments which show similar hydrological response and can be used for a focused regionalization approach on low flow data. A mathematical link between streamflow duration curves and recession curves is herein provided, thus furnishing streamflow duration curves information upon a temporal sequence of data. In such a way, by introducing assumptions on recession curves, the chronological sequence upon low flow data can also be attributed to FDCs, which are known to lack this information by nature.

Keywords: chronological sequence of discharges, recession curves, streamflow duration curves, water concession

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Authors: Farah Syazwani Hilmy Zaki

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Background: Compared to adult cardiopulmonary resuscitation (CPR), high-quality research and evidence on pediatric CPR remain relatively scarce. This knowledge gap hinders the development of optimal guidelines and best practices for resuscitating children. Objectives: To explore pediatric intensive care unit (PICU) CPR current practices in PICU of Institut Jantung Negara (IJN) Malaysia. Method: The research employed a qualitative approach, utilising case study research design. The data collection process involved in-depth interviews and reviewing the Resuscitation Feedback Form. Purposive sampling was used to select two cases consisting of 14 participants. The study participants comprised a cardiologist, one anaesthetist, and twelve nurses. The data collected were transcribed and entered into NVivo software to facilitate theme development. Subsequently, thematic analysis was conducted to analyse the data. Findings: The study yielded key findings regarding the enhancement of PICU CPR practices. These findings are categorised into four themes, namely routine procedures, resuscitation techniques, team dynamics, and individual contributions. Establishment of cohesive team is crucial in facilitating the effectiveness of resuscitation. According to participants, lack of confidence, skills and knowledge presents significant obstacles to effective PICU CPR. Conclusion: The findings of this study indicate that the participants express satisfaction with the current practices of PICU CPR. However, the research also highlights the need for enhancements in various areas, including routine procedures, resuscitation techniques, as well as team and individual factors. Furthermore, it was suggested that additional training be conducted on the resuscitation process to enhance the preparedness of the medical team.

Keywords: cardiopulmonary resuscitation, feedback, nurses, pediatric intensive care unit

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Authors: Lucy Lugo Mawang

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Educational Psychologists have highlighted the significance of creativity in education. Likewise, a fundamental objective of music education concern the development of students’ musical creativity potential. The purpose of this study was to determine the relationship between motivation strategies and musical creativity, and establish the prediction equation of musical creativity. The study used purposive sampling and census to select 201 fourth-form music students (139 females/ 62 males), mainly from public secondary schools in Kenya. The mean age of participants was 17.24 years (SD = .78). Framed upon self- determination theory and the dichotomous model of achievement motivation, the study adopted an ex post facto research design. A self-report measure, the Achievement Goal Questionnaire-Revised (AGQ-R) was used in data collection for the independent variable. Musical creativity was based on a creative music composition task and measured by the Consensual Musical Creativity Assessment Scale (CMCAS). Data collected in two separate sessions within an interval of one month. The questionnaire was administered in the first session, lasting approximately 20 minutes. The second session was for notation of participants’ creative composition. The results indicated a positive correlation r(199) = .39, p ˂ .01 between musical creativity and intrinsic music motivation. Conversely, negative correlation r(199) = -.19, p < .01 was observed between musical creativity and extrinsic music motivation. The equation for predicting musical creativity from music motivation strategies was significant F(2, 198) = 20.8, p < .01, with R2 = .17. Motivation strategies accounted for approximately (17%) of the variance in participants’ musical creativity. Intrinsic music motivation had the highest significant predictive value (β = .38, p ˂ .01) on musical creativity. In the exploratory analysis, a significant mean difference t(118) = 4.59, p ˂ .01 in musical creativity for intrinsic and extrinsic music motivation was observed in favour of intrinsically motivated participants. Further, a significant gender difference t(93.47) = 4.31, p ˂ .01 in musical creativity was observed, with male participants scoring higher than females. However, there was no significant difference in participants’ musical creativity based on age. The study recommended that music educators should strive to enhance intrinsic music motivation among students. Specifically, schools should create conducive environments and have interventions for the development of intrinsic music motivation since it is the most facilitative motivation strategy in predicting musical creativity.

Keywords: extrinsic music motivation, intrinsic music motivation, musical creativity, music composition

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