Search results for: traffic information quality
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 19414

Search results for: traffic information quality

2944 Destination of the PhDs: Determinants of International Mobility of UK PhD Graduates

Authors: Anna Siuda-Bak

Abstract:

This paper adopts a comparative approach to examining the determinants of international mobility of German, Italian and British researchers who completed their doctoral education in the UK. Structured sampling and data collection techniques have been developed in order to retrieve information on participants from publicly available sources. This systematically collected data was supplemented with an on-line survey which captures participants’ job trajectories, including movements between positions, institutions and countries. In total, data on 949 German, Italian and British PhDs was collected. Logistic regression was employed to identify factors associated with one’s probability of moving outside the UK after his or her graduation. The predictor variables included factors associated with one’s PhD (field of study, ranking of the university which awarded the PhD degree) and family factors (having a child, nationality of the partner). Then, 9 constrained models were estimated to test the effect each variable has on probability of going to a specific destination, being English-speaking country, non-English speaking country or returning to the home country. The results show that females, arts and humanities graduates, and respondents with a partner from the UK are less mobile than their counterparts. The effect of the ranking of the university differed in two groups. The UK graduates from higher ranked universities were more likely to move abroad than to stay in the UK after their graduation. In contrast, non-UK natives from the same universities were less likely to be internationally mobile than non-UK natives from lower ranked universities. The nationality of the partner was the most important predictor of the specific destination choices. Graduates with partner from the home county were more likely to return home and those with a partner from the third country least likely to return.

Keywords: doctoral graduates, international mobility, nationality, UK

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2943 Polarisation in Latin America: Examining the Role of Social Media in Ideological Positioning Based on 2018 Census Data

Authors: Sarah Ledoux

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This paper analyses the quantitative effects of political content consumption in social media platforms on self-reported ideological preference across the Latin American region. Initially praising the democratic potential of the internet and its social networking websites, digital politics scholars have transitioned their discourse to warning against the undemocratic side-effects it cultivates, such as hate speech, filter bubbles, and ideological polarisation. Holding technology solely responsible for political trends worldwide is an oversimplification of the factors influencing social change. Nonetheless, widespread use of social media in new democracies raises questions on the reproduction of recent trends that have been observed in the US and Western Europe. Through the analysis of ordered logistic regressions on data from the 2018 AmericasBarometer survey, this study examines the extent to which the relationship between the consumption of political content on social media is related to ideological polarisation in Latin America. The findings indicate that there is a close link between consumption of political information on social media, specifically on Facebook and WhatsApp, and ideological positioning on the extremes of the political left- and right-wings. This relation holds when controlling for individual-level demographic and attitudinal factors, as well as country-level effects. These results demonstrate with empirical evidence that viewing political content on social media has a significant positive effect on the likelihood that citizens position themselves on the extreme ends of the left-right ideological spectrum and implies that political polarisation is a phenomenon that accompanies politically driven social media use.

Keywords: Latin America, polarisation, political consumption, political ideology, social media, survey

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2942 Cultural Heritage, Urban Planning and the Smart City in Indian Context

Authors: Paritosh Goel

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The conservation of historic buildings and historic Centre’s over recent years has become fully encompassed in the planning of built-up areas and their management following climate changes. The approach of the world of restoration, in the Indian context on integrated urban regeneration and its strategic potential for a smarter, more sustainable and socially inclusive urban development introduces, for urban transformations in general (historical centers and otherwise), the theme of sustainability. From this viewpoint, it envisages, as a primary objective, a real “green, ecological or environmental” requalification of the city through interventions within the main categories of sustainability: mobility, energy efficiency, use of sources of renewable energy, urban metabolism (waste, water, territory, etc.) and natural environment. With this the concept of a “resilient city” is also introduced, which can adapt through progressive transformations to situations of change which may not be predictable, behavior that the historical city has always been able to express. Urban planning on the other hand, has increasingly focused on analyses oriented towards the taxonomic description of social/economic and perceptive parameters. It is connected with human behavior, mobility and the characterization of the consumption of resources, in terms of quantity even before quality to inform the city design process, which for ancient fabrics, and mainly affects the public space also in its social dimension. An exact definition of the term “smart city” is still essentially elusive, since we can attribute three dimensions to the term: a) That of a virtual city, evolved based on digital networks and web networks b) That of a physical construction determined by urban planning based on infrastructural innovation, which in the case of historic Centre’s implies regeneration that stimulates and sometimes changes the existing fabric; c) That of a political and social/economic project guided by a dynamic process that provides new behavior and requirements of the city communities that orients the future planning of cities also through participation in their management. This paper is a preliminary research into the connections between these three dimensions applied to the specific case of the fabric of ancient cities with the aim of obtaining a scientific theory and methodology to apply to the regeneration of Indian historical Centre’s. The Smart city scheme if contextualize with heritage of the city it can be an initiative which intends to provide a transdisciplinary approach between various research networks (natural sciences, socio-economics sciences and humanities, technological disciplines, digital infrastructures) which are united in order to improve the design, livability and understanding of urban environment and high historical/cultural performance levels.

Keywords: historical cities regeneration, sustainable restoration, urban planning, smart cities, cultural heritage development strategies

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2941 Impact of School-Based Gymnastic Program on Skill-Related Fitness in Early Adolescent Students

Authors: Dinko Vuleta, Dejan Madić, Goran Sporiš, Nebojša Trajković

Abstract:

The aim of this study was to determine the effects of gymnastics program in school on skill-related fitness in early adolescent students. The study involved 58 adolescent students (12.82±0.54 years; Height 156.81±8.16 cm; 53.46±12.31 kg) from primary school divided into two groups, following the randomization. The gymnastic group was involved in a 12 week of gymnastics classes, while the control group only participated in usual PE classes which consisted of multi-sport activities. The variables were selected within the several fitness batteries, measuring coordination (polygon backwards), upper and lower body strength standing long jump and medicine ball throw), speed (20 m sprint) and agility (4x10 test). Pre-test to post-test values showed significant improvements in all tested variables (p<0.05), except for the 4x10m test, where there were no significant improvements in neither of the groups (p>0.05). Significant interactions of time by group were observed for coordination, sprint speed, standing long jump and medicine ball throw (p<0.05). The results showed significant increase in skill-related fitness of the participants in the gymnastic group compared to the control group. Therefore, participation in gymnastics must be recommended as a positive foundational activity for school-aged children, from early childhood to adulthood. Additionally, the results can provide useful information in optimizing the training loads of pupils involved in gymnastic training throughout PE classes.

Keywords: effects, PE classes, physical fitness, training

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2940 Sharing Tacit Knowledge: The Essence of Knowledge Management

Authors: Ayesha Khatun

Abstract:

In 21st century where markets are unstable, technologies rapidly proliferate, competitors multiply, products and services become obsolete almost overnight and customers demand low cost high value product, leveraging and harnessing knowledge is not just a potential source of competitive advantage rather a necessity in technology based and information intensive industries. Knowledge management focuses on leveraging the available knowledge and sharing the same among the individuals in the organization so that the employees can make best use of it towards achieving the organizational goals. Knowledge is not a discrete object. It is embedded in people and so difficult to transfer outside the immediate context that it becomes a major competitive advantage. However, internal transfer of knowledge among the employees is essential to maximize the use of knowledge available in the organization in an unstructured manner. But as knowledge is the source of competitive advantage for the organization it is also the source of competitive advantage for the individuals. People think that knowledge is power and sharing the same may lead to lose the competitive position. Moreover, the very nature of tacit knowledge poses many difficulties in sharing the same. But sharing tacit knowledge is the vital part of knowledge management process because it is the tacit knowledge which is inimitable. Knowledge management has been made synonymous with the use of software and technology leading to the management of explicit knowledge only ignoring personal interaction and forming of informal networks which are considered as the most successful means of sharing tacit knowledge. Factors responsible for effective sharing of tacit knowledge are grouped into –individual, organizational and technological factors. Different factors under each category have been identified. Creating a positive organizational culture, encouraging personal interaction, practicing reward system are some of the strategies that can help to overcome many of the barriers to effective sharing of tacit knowledge. Methodology applied here is completely secondary. Extensive review of relevant literature has been undertaken for the purpose.

Keywords: knowledge, tacit knowledge, knowledge management, sustainable competitive advantage, organization, knowledge sharing

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2939 The Copyright Eligibility of Sports Events and Performances

Authors: Emre Bayamlıoğlu

Abstract:

Apart from being the subject of neighboring rights when broadcasted on TV or of cinematographic work when fixed to a tangible medium including a hard drive, the copyright eligibility of a sports performance, and eventually the sporting event has once again given rise to controversy following the CJEU judgment in the Murphy case. Most of the arguments which deny copyright protection for sports performances focus on the fact that unlike movies, plays, television programs, or operas, athletic events are competitive and have no underlying script. The first part of the paper aims to explain that such rhetoric is rather weak simply for the fact that, several types of performances such as improvised musical or dramatic shows are still protected by copyright despite the fact that they are not based on a script. The second part argues that the core reason for the denial copyright protection was the functionality aiming certain practical results such as winning the game, scoring, eliminating an opponent, obstructing a shot and etc., but no scientific or artistic expression in whatsoever form. The paper further argues that expanding copyright protection to functional performances would give rise to unintended copyright claims by the athletes on tackles, shoots, passes, crosses etc. resulting with further restrictions on reporting and photographing of sporting events. The final part provides a policy analysis of the trend to broaden the scope of copyright to cover sports performances. It is argued that such expansion will clearly undermine the ratio legis of copyright laws since it will give rise to excessive commodification of information beyond the needs of a viable market economy. Therefore, remedies other than copyright protection such as unfair competition and unjust enrichment provides sufficient redress for the damages to be sustained by the investors of sporting events.

Keywords: copyright eligibility, idea-expression dichotomy, sports performance

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2938 Nutritional Status of Children in a Rural Food Environment, Haryana: A Paradox for the Policy Action

Authors: Neha Gupta, Sonika Verma, Seema Puri, Nikhil Tandon, Narendra K. Arora

Abstract:

The concurrent increasing prevalence of underweight and overweight/obesity among children with changing lifestyle and the rapid transitioning society has necessitated the need for a unifying/multi-level approach to understand the determinants of the problem. The present community-based cross-sectional research study was conducted to assess the associations between lifestyle behavior and food environment of the child at household, neighborhood, and school with the BMI of children (6-12 year old) (n=612) residing in three rural clusters of Palwal district, Haryana. The study used innovative and robust methods for assessing the lifestyle and various components of food environment in the study. The three rural clusters selected for the study were located at three different locations according to their access to highways in the SOMAARTH surveillance site. These clusters were significantly different from each other in terms of their socio-demographic and socio-economic profile, living conditions, environmental hygiene, health seeking behavior and retail density. Despite of being different, the quality of living conditions and environmental hygiene was poor across three clusters. The children had higher intakes of dietary energy and sugars; one-fifth share of the energy being derived from unhealthy foods, engagement in high levels of physical activity and significantly different food environment at home, neighborhood and school level. However, despite having a high energy intake, 22.5% of the recruited children were thin/severe thin, and 3% were overweight/obese as per their BMI-for-age categories. The analysis was done using multi-variate logistic regression at three-tier hierarchy including individual, household and community level. The factors significantly explained the variability in governing the risk of getting thin/severe thin among children in rural area (p-value: 0.0001; Adjusted R2: 0.156) included age (>10years) (OR: 2.1; 95% CI: 1.0-4.4), the interaction between minority category and poor SES of the household (OR: 4.4; 95% CI: 1.6-12.1), availability of sweets (OR: 0.9; 95% CI: 0.8-0.99) and cereals (OR: 0.9; 95% CI: 0.8-1.0) in the household and poor street condition (proxy indicator of the hygiene and cleanliness in the neighborhood) (OR: 0.3; 95% CI: 0.1-1.1). The homogeneity of other factors at neighborhood and school level food environment diluted the heterogeneity in the lifestyles and home environment of the recruited children and their households. However, it is evident that when various individual factors interplay at multiple levels amplifies the risk of undernutrition in a rural community. Conclusion: These rural areas in Haryana are undergoing developmental, economic and societal transition. In correspondence, no improvements in the nutritional status of children have happened. Easy access to the unhealthy foods has become a paradox.

Keywords: transition, food environment, lifestyle, undernutrition, overnutrition

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2937 Perceptions About the Academic Performance of Autistic Students

Authors: Afaf Alhusayni, Elizabeth Sheppard, Asiyya Jaffrani, Peter Mitchell, Lauren Marsh

Abstract:

Introduction: Previous research has found that people make systematic judgments about others based on small glimpses of their behavior. Furthermore, autistic people are consistently judged more negatively than non-autistic people in terms of favourability and approachability. Objectives: This project focuses on a hitherto unstudied type of judgment that is highly relevant within a university context, judgments about academic performance. This is particularly important as autistic university students are less likely to complete their degrees than neurotypical students. Methods: Twenty-five neurotypical perceivers (21 females - 4 males) viewed a series of 4s video clips featuring an individual ‘target’ displaying natural behavior. Nine of these targets were autistic and nine were neurotypical. Perceivers were asked to rate each target on four aspects related to university life (motivation, success, grades, and happiness). Results: Autistic targets were judged more negatively on all aspects compared to neurotypical targets. Conclusions: This study concludes that neurotypical perceivers negatively judge the academic performance of autistic students. This suggests that autistic university students face unfavorable scrutiny and judgment, which may negatively impact their academic success. Implications: These initial findings provide important evidence that autistic people are negatively stigmatized within education environments. Further work is needed to ascertain the extent to which these negative judgments may feed into attainment gaps for autistic students. This information is useful for the education department, government, and social care organizations, enabling change in the provision of support for autistic students.

Keywords: autistic person perception, academic performance, stigma and judgment, higher education

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2936 In vitro Regeneration of Neural Cells Using Human Umbilical Cord Derived Mesenchymal Stem Cells

Authors: Urvi Panwar, Kanchan Mishra, Kanjaksha Ghosh, ShankerLal Kothari

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Background: Day-by-day the increasing prevalence of neurodegenerative diseases have become a global issue to manage them by medical sciences. The adult neural stem cells are rare and require an invasive and painful procedure to obtain it from central nervous system. Mesenchymal stem cell (MSCs) therapies have shown remarkable application in treatment of various cell injuries and cell loss. MSCs can be derived from various sources like adult tissues, human bone marrow, umbilical cord blood and cord tissue. MSCs have similar proliferation and differentiation capability, but the human umbilical cord-derived mesenchymal stem cells (hUCMSCs) are proved to be more beneficial with respect to cell procurement, differentiation to other cells, preservation, and transplantation. Material and method: Human umbilical cord is easily obtainable and non-controversial comparative to bone marrow and other adult tissues. The umbilical cord can be collected after delivery of baby, and its tissue can be cultured using explant culture method. Cell culture medium such as DMEMF12+10% FBS and DMEMF12+Neural growth factors (bFGF, human noggin, B27) with antibiotics (Streptomycin/Gentamycin) were used to culture and differentiate mesenchymal stem cells into neural cells, respectively. The characterisations of MSCs were done with Flow Cytometer for surface markers CD90, CD73 and CD105 and colony forming unit assay. The differentiated various neural cells will be characterised by fluorescence markers for neurons, astrocytes, and oligodendrocytes; quantitative PCR for genes Nestin and NeuroD1 and Western blotting technique for gap43 protein. Result and discussion: The high quality and number of MSCs were isolated from human umbilical cord via explant culture method. The obtained MSCs were differentiated into neural cells like neurons, astrocytes and oligodendrocytes. The differentiated neural cells can be used to treat neural injuries and neural cell loss by delivering cells by non-invasive administration via cerebrospinal fluid (CSF) or blood. Moreover, the MSCs can also be directly delivered to different injured sites where they differentiate into neural cells. Therefore, human umbilical cord is demonstrated to be an inexpensive and easily available source for MSCs. Moreover, the hUCMSCs can be a potential source for neural cell therapies and neural cell regeneration for neural cell injuries and neural cell loss. This new way of research will be helpful to treat and manage neural cell damages and neurodegenerative diseases like Alzheimer and Parkinson. Still the study has a long way to go but it is a promising approach for many neural disorders for which at present no satisfactory management is available.

Keywords: bone marrow, cell therapy, explant culture method, flow cytometer, human umbilical cord, mesenchymal stem cells, neurodegenerative diseases, neuroprotective, regeneration

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2935 Translation and Adaptation of Computer Assisted ASPIRA Smoking Prevention Program in Romania

Authors: Z. Abram, V. Nadasan, J. Balint, J. L. Ferencz

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Introduction: Online smoking prevention programs became popular in the last time. In order to extend the use of such programs, existing applications can be adapted and translated in the native languages of the target groups. It is the first time that in Romania such a software was implemented. Our goal was to provide a computer-aided intervention with attractive content targeting high school students who are familiar with information and communication technology. Material and methods: ASPIRA is the Romanian/Hungarian adapted version of a smoking prevention program created in USA. Prior to apply the questionnaire and ASPIRA online program which contains five modules that include tests, videos and interactive games, the program was tested in some IT laboratories on a group of schoolchildren and students. The pilot study questionnaires were completed considering the opinions of young people and the functionality of the software. Results: Above 90% of participants reported a good or very good impression about the ASPIRA program. Only a small minority found that the program included some parts which were too long or reported the existence of any technical problems regarding the functionality of the software. 76% of the participants had little or very little difficulty in understanding the messages presented by the English speaking characters. Only 7.5% of the participants thought that the program included content that was not appropriate for the local culture. Conclusions: The vast majority of students reported favorite impressions about ASPIRA online program. High school students and boys were more critical. Language and cultural barriers did not have the potential to reduce in a significant manner the effectiveness of the tested program.

Keywords: smoking prevention, ASPIRA online program, youth opinions, language/cultural barriers

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2934 Stimulating Young Children Social Interaction Behaviour through Computer Play Activities: The Role of Teachers and Parents Support

Authors: Mahani Razali, Nordin Mamat

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The purpose of the study is to explore how computer technology is integrated into pre-school activities and its relationship with children’s social interaction behaviour in pre-school classroom. The major question of interest in the present study is to investigate the social interaction behaviour of children when using computers in the Malaysian pre-school classroom. This research is based on three main objectives which are to identify children`s social interaction during computer play activities, teacher’s role and parent’s participation to develop children`s social interaction. 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 social interaction behaviour among pre-school children through computer play activities; as for semi-structured interviews, it was done to study the perception of the teachers and parents on the acquired social interaction behaviour 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 social interaction behaviour elements among the pre-school children. Findings revealed that the children showed positive outcomes on the social interaction behaviour during their computer play. This research summarizes that teacher’s role and parent’s support can improve children`s social interaction behaviour through computer play activities. As a whole, this research highlighted the significance of computer play activities as to stimulate social interaction behavior among the pre-school children.

Keywords: early childhood, emotional development, parent support, play

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2933 Technical Aspects of Closing the Loop in Depth-of-Anesthesia Control

Authors: Gorazd Karer

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When performing a diagnostic procedure or surgery in general anesthesia (GA), a proper introduction and dosing of anesthetic agents are one of the main tasks of the anesthesiologist. However, depth of anesthesia (DoA) also seems to be a suitable process for closed-loop control implementation. To implement such a system, one must be able to acquire the relevant signals online and in real-time, as well as stream the calculated control signal to the infusion pump. However, during a procedure, patient monitors and infusion pumps are purposely unable to connect to an external (possibly medically unapproved) device for safety reasons, thus preventing closed-loop control. The paper proposes a conceptual solution to the aforementioned problem. First, it presents some important aspects of contemporary clinical practice. Next, it introduces the closed-loop-control-system structure and the relevant information flow. Focusing on transferring the data from the patient to the computer, it presents a non-invasive image-based system for signal acquisition from a patient monitor for online depth-of-anesthesia assessment. Furthermore, it introduces a UDP-based communication method that can be used for transmitting the calculated anesthetic inflow to the infusion pump. The proposed system is independent of a medical device manufacturer and is implemented in Matlab-Simulink, which can be conveniently used for DoA control implementation. The proposed scheme has been tested in a simulated GA setting and is ready to be evaluated in an operating theatre. However, the proposed system is only a step towards a proper closed-loop control system for DoA, which could routinely be used in clinical practice.

Keywords: closed-loop control, depth of anesthesia (DoA), modeling, optical signal acquisition, patient state index (PSi), UDP communication protocol

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2932 Russia’s Role in Resolving the Nagorno-Karabakh Conflict 1990-2020

Authors: Friba Haidari

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The aim of the study is to identify Russia's role in managing the Nagorno-Karabakh conflict betweenArmenia and Azerbaijan during the years 1990 to 2020. The Nagorno-Karabakh crisis can not be considered a mere territorial conflict but also a crossroads of interests of foreign actors. Geopolitical rivalries and the access to energy by regional and trans-regional actors have complicated the crisis and created a security challenge in the region, which is likely to escalate into a full-blown war between the parties involved. The geopolitical situation of Nagorno-Karabakh and its current situation have affected all peripheral states in some way. Russia, as one of the main actors in this scene, has been actively involved since the beginning of the crisis. The Russians have always sought to strengthen their influence and presence in the Nagorno-Karabakh crisis. Russia's efforts to weaken the role of the Minsk Group, The presence of Western actors, and the deployment of Russian forces in the disputed area can be assessed in this context. However, this study seeks to answer the question of what role did Russia play in managing the Nagorno-Karabakh conflict between Armenia and Azerbaijan between 1990 and 2020? The study hypothesizes that Russia has prevented the escalation of the Nagorno-Karabakh conflict through mediation and some coercion. This study is divided into four parts, including conflict management as a theoretical framework; Examining the competition and the role of actors in the Caucasus region, especially the role of the Minsk Group, and what approach or tools and methods Russia has used in its foreign policy in managing the conflict, and finally what are the relations between the countries involved and what will be Russia's role in the future? Was discussed. This study examines the analysis and transfer of ideas and information using authoritative international sources with an explanatory method and shares its results with everyone.

Keywords: Russia, conflict, nagorno-karabakh, management

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2931 StockTwits Sentiment Analysis on Stock Price Prediction

Authors: Min Chen, Rubi Gupta

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Understanding and predicting stock market movements is a challenging problem. It is believed stock markets are partially driven by public sentiments, which leads to numerous research efforts to predict stock market trend using public sentiments expressed on social media such as Twitter but with limited success. Recently a microblogging website StockTwits is becoming increasingly popular for users to share their discussions and sentiments about stocks and financial market. In this project, we analyze the text content of StockTwits tweets and extract financial sentiment using text featurization and machine learning algorithms. StockTwits tweets are first pre-processed using techniques including stopword removal, special character removal, and case normalization to remove noise. Features are extracted from these preprocessed tweets through text featurization process using bags of words, N-gram models, TF-IDF (term frequency-inverse document frequency), and latent semantic analysis. Machine learning models are then trained to classify the tweets' sentiment as positive (bullish) or negative (bearish). The correlation between the aggregated daily sentiment and daily stock price movement is then investigated using Pearson’s correlation coefficient. Finally, the sentiment information is applied together with time series stock data to predict stock price movement. The experiments on five companies (Apple, Amazon, General Electric, Microsoft, and Target) in a duration of nine months demonstrate the effectiveness of our study in improving the prediction accuracy.

Keywords: machine learning, sentiment analysis, stock price prediction, tweet processing

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2930 Attribution Theory and Perceived Reliability of Cellphones for Teaching and Learning

Authors: Mayowa A. Sofowora, Seraphin D. Eyono Obono

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The use of information and communication technologies such as computers, mobile phones and the internet is becoming prevalent in today’s world; and it is facilitating access to a vast amount of data, services, and applications for the improvement of people’s lives. However, this prevalence of ICTs is hampered by the problem of low income levels in developing countries to the point where people cannot timeously replace or repair their ICT devices when damaged or lost; and this problem serves as a motivation for this study whose aim is to examine the perceptions of teachers on the reliability of cellphones when used for teaching and learning purposes. The research objectives unfolding this aim are of two types: objectives on the selection and design of theories and models, and objectives on the empirical testing of these theories and models. The first type of objectives is achieved using content analysis in an extensive literature survey, and the second type of objectives is achieved through a survey of high school teachers from the ILembe and Umgungudlovu districts in the KwaZuluNatal province of South Africa. Data collected from this questionnaire based survey is analysed in SPSS using descriptive statistics and Pearson correlations after checking the reliability and validity of the questionnaire. The main hypothesis driving this study is that there is a relationship between the demographics and the attribution identity of teachers on one hand, and their perceptions on the reliability of cellphones on the other hand, as suggested by existing literature; except that attribution identities are considered in this study under three angles: intention, knowledge and ability, and action. The results of this study confirm that the perceptions of teachers on the reliability of cellphones for teaching and learning are affected by the school location of these teachers, and by their perceptions on learners’ cellphones usage intentions and actual use.

Keywords: attribution, cellphones, e-learning, reliability

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2929 The Cultural Persona of Artificial Intelligence: An Analysis of Anthropological Challenges to Public Communication

Authors: Abhivardhan, Ritu Agarwal

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The role of entrepreneurial ethics is connected with materializing the core components of human life, and the flexible and gullible attributions dominate the materialization of human lifestyle and outreach in the age of the internet and globalization. One of the key bi-products of the age of information – Artificial Intelligence has become a relevant mechanism to materialize and understand human empathy and originality via various algorithmic policing methodologies with specific intricacies. Since it has a special connection with ethnocentrism – it has the potential to influence the approach of international law and politics owed to the rise of and approach towards perception and communication via populism in progressive and third world countries. The paper argues about the cultural persona of artificial intelligence, and its ontological resemblance in human life is connected with the ethnocentric treatment of cyberspace, with an analysis of the influence of the ethics of entrepreneurship in international politics. The paper further provides an analysis of fake news and misinformation as the sub-strata of communication strategies involving populism determined as a communication strategy and about the legal case of constitutional redemption in recent legislative developments in Europe, the U.S, and Asia with reference to certain important strategies, policy documentation, declarations, and legal instruments. The paper concludes that the capillaries of the anthropomorphic developments of cultural perception via towards artificial intelligence have a hidden and unstable connection with the common approach of entrepreneurial ethics, which influences populism to disrupt the peaceful order of international politics via some minor backlashes in the technological, legal and social realm of human life. Suggestions with the conclusion are hereby provided.

Keywords: ethnocentrism, perception politics, populism, international law, slacktivism, artificial intelligence ethics, enculturation

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2928 Chemical Study of Volatile Organic Compounds (VOCS) from Xylopia aromatica (LAM.) Mart (Annonaceae)

Authors: Vanessa G. P. Severino, JOÃO Gabriel M. Junqueira, Michelle N. G. do Nascimento, Francisco W. B. Aquino, João B. Fernandes, Ana P. Terezan

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The scientific interest in analyzing VOCs represents a significant modern research field as a result of importance in most branches of the present life and industry. Therefore it is extremely important to investigate, identify and isolate volatile substances, since they can be used in different areas, such as food, medicine, cosmetics, perfumery, aromatherapy, pesticides, repellents and other household products through methods for extracting volatile constituents, such as solid phase microextraction (SPME), hydrodistillation (HD), solvent extraction (SE), Soxhlet extraction, supercritical fluid extraction (SFE), stream distillation (SD) and vacuum distillation (VD). The Chemometrics is an area of chemistry that uses statistical and mathematical tools for the planning and optimization of the experimental conditions, and to extract relevant chemical information multivariate chemical data. In this context, the focus of this work was the study of the chemical VOCs by SPME of the specie X. aromatica, in search of constituents that can be used in the industrial sector as well as in food, cosmetics and perfumery, since these areas industrial has a considerable role. In addition, by chemometric analysis, we sought to maximize the answers of this research, in order to search for the largest number of compounds. The investigation of flowers from X. aromatica in vitro and in alive mode proved consistent, but certain factors supposed influence the composition of metabolites, and the chemometric analysis strengthened the analysis. Thus, the study of the chemical composition of X. aromatica contributed to the VOCs knowledge of the species and a possible application.

Keywords: chemometrics, flowers, HS-SPME, Xylopia aromatica

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2927 Effects of Dietary Polyunsaturated Fatty Acids and Beta Glucan on Maturity, Immunity, and Fry Quality of Pabdah Catfish, Ompok pabda

Authors: Zakir Hossain, Saddam Hossain

Abstract:

A nutritionally balanced diet and selection of appropriate species are important criteria in aquaculture. The present study was conducted to evaluate the effects of polyunsaturated fatty acids (PUFAs) and beta glucan-containing diets on growth performance, feed utilization, maturation, immunity, early embryonic and larval development of endangered Pabdah catfish, Ompok pabda. In this study, squid extracted lipids and mushroom powder were used as the source of PUFAs and beta-glucan, respectively, and formulated two isonitrogenous diets such as a basal or control (CON) diet and a treated (PBG) diet with maintaining 30% protein levels. During the study period, similar physicochemical conditions of water such as temperature, pH, and dissolved oxygen (DO) were 26.5±2 °C, 7.4±0.2, and 6.7±0.5 ppm, respectively, in each cistern. The results showed that final mean body weight, final mean length gain, food conversion ratio (FCR), specific growth rate (SGR), food conversion efficiency (%), hepato somatic index (HSI), kidney index (KI), and viscerosomatic index (VSI) were significantly (P<0.01 and P<0.05) higher in fish fed the PBG diet than that of fish fed the CON diet. The length-weight relationship and relative condition factor (K) of O. pabda were significantly (P<0.05) affected by the PBG diet. The gonadosomatic index (GSI), sperm viability, blood serum calcium ion concentrations (Ca²⁺), and vitellogenin level were significantly (P<0.05) higher in fish fed the PBG diet than that of fish fed the CON diet; which was used to the indication of fish maturation. During the spawning season, lipid granules and normal morphological structure were observed in the treated fish liver, whereas fewer lipid granules of liver were observed in the control group. Based on the immunity and stress resistance-related parameters such as hematological indices, antioxidant activity, lysozyme level, respiratory burst activity, blood reactive oxygen species (ROS), complement activity (ACH50 assay), specific IgM, brain AChE, plasma PGOT, and PGPT enzyme activity were significantly (P<0.01 and P<0.05) higher in fish fed the PBG diet than that of fish fed the CON diet. The fecundity, fertilization rate (92.23±2.69%), hatching rate (87.43±2.17 %), and survival (76.62±0.82%) of offspring were significantly higher (P˂0.05) in the PBG diet than in control. Consequently, early embryonic and larval development was better in PBG treated group than in control. Therefore, the present study showed that the polyunsaturated fatty acids (PUFAs) and beta-glucan enriched experimental diet were more effective and achieved better growth, feed utilization, maturation, immunity, and spawning performances of O. pabda.

Keywords: lipids, beta-glucan, fish maturity, fish immunity

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2926 Applied Spatial Mapping and Monitoring of Illegal Landfills for Deprived Urban Areas in Romania

Authors: Șercăianu Mihai, Aldea Mihaela, Iacoboaea Cristina, Luca Oana, Nenciu Ioana

Abstract:

The rise and mitigation of unauthorized illegal waste dumps are a significant global issue within waste management ecosystems, impacting disadvantaged communities. Globally, including in Romania, many individuals live in houses without legal recognition, lacking ownership or construction permits, in areas known as "informal settlements." An increasing number of regions and cities in Romania are struggling to manage their illegal waste dumps, especially in the context of increasing poverty and lack of regulation related to informal settlements. One such informal settlement is located at the end of Bistra Street in Câlnic, within the Reșița Municipality of Caras Severin County. The article presents a case study that focuses on employing remote sensing techniques and spatial data to monitor and map illegal waste practices, with subsequent integration into a geographic information system tailored for the Reșița community. In addition, the paper outlines the steps involved in devising strategies aimed at enhancing waste management practices in disadvantaged areas, aligning with the shift toward a circular economy. Results presented in the paper contain a spatial mapping and visualization methodology calibrated with in situ data collection applicable for identifying illegal landfills. The emergence and neutralization of illegal dumps pose a challenge in the field of waste management. These approaches, which prove effective where conventional solutions have failed, need to be replicated and adopted more wisely.

Keywords: informal settlements, GIS, waste dumps, waste management, monitoring

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2925 Next Generation UK Storm Surge Model for the Insurance Market: The London Case

Authors: Iacopo Carnacina, Mohammad Keshtpoor, Richard Yablonsky

Abstract:

Non-structural protection measures against flooding are becoming increasingly popular flood risk mitigation strategies. In particular, coastal flood insurance impacts not only private citizens but also insurance and reinsurance companies, who may require it to retain solvency and better understand the risks they face from a catastrophic coastal flood event. In this context, a framework is presented here to assess the risk for coastal flooding across the UK. The area has a long history of catastrophic flood events, including the Great Flood of 1953 and the 2013 Cyclone Xaver storm, both of which led to significant loss of life and property. The current framework will leverage a technology based on a hydrodynamic model (Delft3D Flexible Mesh). This flexible mesh technology, coupled with a calibration technique, allows for better utilisation of computational resources, leading to higher resolution and more detailed results. The generation of a stochastic set of extra tropical cyclone (ETC) events supports the evaluation of the financial losses for the whole area, also accounting for correlations between different locations in different scenarios. Finally, the solution shows a detailed analysis for the Thames River, leveraging the information available on flood barriers and levees. Two realistic disaster scenarios for the Greater London area are simulated: In the first scenario, the storm surge intensity is not high enough to fail London’s flood defences, but in the second scenario, London’s flood defences fail, highlighting the potential losses from a catastrophic coastal flood event.

Keywords: storm surge, stochastic model, levee failure, Thames River

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2924 Cost-Effectiveness of Forest Restoration in Nepal: A Case from Leasehold Forestry Initiatives

Authors: Sony Baral, Bijendra Basnyat, Kalyan Gauli

Abstract:

Forests are depleted throughout the world in the 1990s, and since then, various efforts have been undertaken for the restoration of the forest. A government of Nepal promoted various community based forest management in which leasehold forestry was the one introduce in 1990s, aiming to restore degraded forests land. However, few attempts have been made to systematically evaluate its cost effectiveness. Hence the study assesses the cost effectiveness of leasehold forestry intervention in the mid-hill district of Nepal following the cost and benefit analysis approach. The study followed quasi-experimental design and collected costs and benefits information from 320 leasehold forestry groups (with intervention) and 154 comparison groups (without intervention) through household survey, forest inventory and then validated with the stakeholders’ consultative workshop. The study found that both the benefits and costs from intervention outweighed without situation. The members of leasehold forestry groups were generating multiple benefits from the forests, such as firewood, grasses, fodder, and fruits, whereas those from comparison groups were mostly getting a single benefit. Likewise, extent of soil carbon is high in leasehold forests. Average expense per unit area is high in intervention sites due to high government investment for capacity building. Nevertheless, positive net present value and internal rate of return was observed for both situations. However, net present value from intervention, i.e., leasehold forestry, is almost double compared to comparison sites, revealing that community are getting higher benefits from restoration. The study concludes that leasehold forestry is a highly cost-effective intervention that contributes towards forest restoration that brings multiple benefits to rural poor.

Keywords: cost effectiveness, economic efficiency, intervention, restoration, leasehold forestry, nepal

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2923 Acceleration-Based Motion Model for Visual Simultaneous Localization and Mapping

Authors: Daohong Yang, Xiang Zhang, Lei Li, Wanting Zhou

Abstract:

Visual Simultaneous Localization and Mapping (VSLAM) is a technology that obtains information in the environment for self-positioning and mapping. It is widely used in computer vision, robotics and other fields. Many visual SLAM systems, such as OBSLAM3, employ a constant-speed motion model that provides the initial pose of the current frame to improve the speed and accuracy of feature matching. However, in actual situations, the constant velocity motion model is often difficult to be satisfied, which may lead to a large deviation between the obtained initial pose and the real value, and may lead to errors in nonlinear optimization results. Therefore, this paper proposed a motion model based on acceleration, which can be applied on most SLAM systems. In order to better describe the acceleration of the camera pose, we decoupled the pose transformation matrix, and calculated the rotation matrix and the translation vector respectively, where the rotation matrix is represented by rotation vector. We assume that, in a short period of time, the changes of rotating angular velocity and translation vector remain the same. Based on this assumption, the initial pose of the current frame is estimated. In addition, the error of constant velocity model was analyzed theoretically. Finally, we applied our proposed approach to the ORBSLAM3 system and evaluated two sets of sequences on the TUM dataset. The results showed that our proposed method had a more accurate initial pose estimation and the accuracy of ORBSLAM3 system is improved by 6.61% and 6.46% respectively on the two test sequences.

Keywords: error estimation, constant acceleration motion model, pose estimation, visual SLAM

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2922 The Use of Metformin in Treatment of Polycystic Ovary Syndrome (PCOS) and Glucose Control in Pregnant Women with Gestational Diabetes Mellitus (GDM) at Tripoli Medical Center

Authors: Ebtisam A. Benomran, Abdurrauf M. Gusbi, Malak S. Elazarg, M. Sultan, Layla M. Kafu, Arwa M. Matoug, Esra E. Benamara

Abstract:

Normal pregnancy is associated with metabolic changes leading to decreased insulin sensitivity and reduced glucose tolerance, however, 3-5% of pregnant women proceed to develop gestational diabetes mellitus (GDM). Researcher studied the use of metformin in many fields and the benefit to risk balance of using metformin during pregnancy and the risk of fetotoxic. In this study we examined the use of Metformin to control Glucose in pregnant Women with gestational diabetes mellitus (GDM) and evaluate its safety use during the first trimester of pregnancy.A group of pregnant patients with gestational diabetes mellitus from the first trimester of pregnancy, non smoking with no family history of congenital malformation disease, aged between (20-45 years) and have no liver diseases and who had indicating good compliance at more than one visit over several month until delivery put on Metformin were participated in this trial. Our study shown that all the studied group of pregnant women using metformin 500 mg daily delivered a healthy babies. Meta-analysis by mother risk program showed no increase in incidence of malformations by use Metformin during the first trimester of pregnancy. A hundred outpatients were participated in the survey on the general knowledge and awareness of diabetic patients to their illness and medication used their aged between 20-40 years old. In this survey we realize that 90% of the doctors are not giving the patient full information about their illness and the use of metformin during pregnancy, also about 65% of the patients did not know about the nutritionist in the hospital and the right control diet for diabetes. Courses on first aid, rapid diagnosis of poisoning and follow the written procedures to dealing with such cases.

Keywords: gestational diabetes, malformations, metformin, pregnancy

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2921 Unveiling Mental Health Nuances of Male Indian Classical Dancers

Authors: Madhura Bapat, Uma Krishnan

Abstract:

Exploring the redefinition of masculinity through the experiences of male Indian classical dancers, this qualitative research focuses on their perceived quality of life, psychosocial challenges, and coping strategies. This study aims to explore the mental health nuances of male Indian classical dancers through an in-depth understanding of their lived experiences with dance. The benefits and personal journeys of dancers, particularly in Indian classical forms, reveal insights into culture, gender, and societal expectations. Men in Indian classical dance frequently encounter stigma due to prevailing gender norms in the arts and society. Acknowledgment of these experiences is key to understanding issues of identity, mental wellness, and communal acceptance of male Indian classical dancers in the Indian dance scenario. This study follows an interpretive phenomenological approach to follow the lived experiences of male Indian classical dancers. Male Indian classical dancers were selected using criterion-based sampling. The participants are male, fluent in English and pursue Indian classical dance styles professionally, like Kathak, Bharatanatyam, Chhau, etc. Six participants were recruited for personal, semi-structured, in-depth interviews. A focus group discussion with four participants was conducted to explore the stigma surrounding their roles. The data were analyzed using interpretive phenomenological analysis (IPA), revealing superordinate themes of (1) identity fragmentation and negotiation in gendered social contexts; (2) gendered constraints and artistic expression; (3) psychosocial distress and mental health challenges; (4) coping mechanisms and resilience; and (5) stigmatization and social integration dynamics. Male Indian classical dancers grapple with identity formation, navigating a paradox of self-perception, artistic identity, and societal expectation. They reported experiencing emasculation, compromising artistic expression, and struggling with gender norms and gendered training constraints. They have faced name-calling, bullying, taunting, slandering, and discrimination. These experiences have led to psychological challenges and distress. However, the paradox continues as male dancers use adaptive coping strategies despite the adversities that intertwine self-perception, societal pressures, and their passion for dance. This research sheds light on the intersection of gender, mental health, and art. These findings provide a strong foundation for making changes in the dance community for acceptance of male dancers, policy making for better job opportunities for male dancers and mental health services to be provided to help them deal with distress. The study offers valuable insights into how male classical dancers navigate stigma and mental health challenges in gendered social contexts, contributing to a deeper understanding of identity formation in the arts.

Keywords: gendered experiences, Indian classical dance, male dancers, mental health, stigma

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2920 Accessibility Assessment of School Facilities Using Geospatial Technologies: A Case Study of District Sheikhupura

Authors: Hira Jabbar

Abstract:

Education is vital for inclusive growth of an economy and a critical contributor for investment in human capital. Like other developing countries, Pakistan is facing enormous challenges regarding the provision of public facilities, improper infrastructure planning, accelerating rate of population and poor accessibility. The influence of the rapid advancement and innovations in GIS and RS techniques have proved to be a useful tool for better planning and decision making to encounter these challenges. Therefore present study incorporates GIS and RS techniques to investigate the spatial distribution of school facilities, identifies settlements with served and unserved population, finds potential areas for new schools based on population and develops an accessibility index to evaluate the higher accessibility for schools. For this purpose high-resolution worldview imagery was used to develop road network, settlements and school facilities and to generate school accessibility for each level. Landsat 8 imagery was utilized to extract built-up area by applying pre and post-processing models and Landscan 2015 was used to analyze population statistics. Service area analysis was performed using network analyst extension in ArcGIS 10.3v and results were evaluated for served and underserved areas and population. An accessibility tool was used to evaluate a set of potential destinations to determine which is the most accessible with the given population distribution. Findings of the study may contribute to facilitating the town planners and education authorities for understanding the existing patterns of school facilities. It is concluded that GIS and remote sensing can be effectively used in urban transport and facility planning.

Keywords: accessibility, geographic information system, landscan, worldview

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2919 Hydrological-Economic Modeling of Two Hydrographic Basins of the Coast of Peru

Authors: Julio Jesus Salazar, Manuel Andres Jesus De Lama

Abstract:

There are very few models that serve to analyze the use of water in the socio-economic process. On the supply side, the joint use of groundwater has been considered in addition to the simple limits on the availability of surface water. In addition, we have worked on waterlogging and the effects on water quality (mainly salinity). In this paper, a 'complex' water economy is examined; one in which demands grow differentially not only within but also between sectors, and one in which there are limited opportunities to increase consumptive use. In particular, high-value growth, the growth of the production of irrigated crops of high value within the basins of the case study, together with the rapidly growing urban areas, provides a rich context to examine the general problem of water management at the basin level. At the same time, the long-term aridity of nature has made the eco-environment in the basins located on the coast of Peru very vulnerable, and the exploitation and immediate use of water resources have further deteriorated the situation. The presented methodology is the optimization with embedded simulation. The wide basin simulation of flow and water balances and crop growth are embedded with the optimization of water allocation, reservoir operation, and irrigation scheduling. The modeling framework is developed from a network of river basins that includes multiple nodes of origin (reservoirs, aquifers, water courses, etc.) and multiple demand sites along the river, including places of consumptive use for agricultural, municipal and industrial, and uses of running water on the coast of Peru. The economic benefits associated with water use are evaluated for different demand management instruments, including water rights, based on the production and benefit functions of water use in the urban agricultural and industrial sectors. This work represents a new effort to analyze the use of water at the regional level and to evaluate the modernization of the integrated management of water resources and socio-economic territorial development in Peru. It will also allow the establishment of policies to improve the process of implementation of the integrated management and development of water resources. The input-output analysis is essential to present a theory about the production process, which is based on a particular type of production function. Also, this work presents the Computable General Equilibrium (CGE) version of the economic model for water resource policy analysis, which was specifically designed for analyzing large-scale water management. As to the platform for CGE simulation, GEMPACK, a flexible system for solving CGE models, is used for formulating and solving CGE model through the percentage-change approach. GEMPACK automates the process of translating the model specification into a model solution program.

Keywords: water economy, simulation, modeling, integration

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2918 Portable Palpation Probe for Diabetic Foot Ulceration Monitoring

Authors: Bummo Ahn

Abstract:

Palpation is widely used to measure soft tissue firmness or stiffness in the living condition in order to apply detection, diagnosis, and treatment of tumors, scar tissue, abnormal muscle tone, or muscle spasticity. Since these methods are subjective and depend on the proficiency level, it is concluded that there are other diagnoses depending on the condition of the experts and the results are not objective. The mechanical property obtained by using the elasticity of the tissue is important to calculate a predictive variable for monitoring abnormal tissues. If the mechanical load such as reaction force on the foot increases in the same region under the same conditions, the mechanical property of the tissue is changed. Therefore, objective diagnosis is possible not only for experts but also for patients using this quantitative information. Furthermore, the portable system also allows non-experts to easily diagnose at home, not in hospitals or institutions. In this paper, we introduce a portable palpation system that can be used to measure the mechanical properties of human tissue, which can be applied to monitor diabetic foot ulceration patients with measuring the mechanical property change of foot tissue. The system was designed to be smaller and portable in comparison with the conventional palpation systems. It is consists of the probe, the force sensor, linear actuator, micro control unit, the display module, battery, and housing. Using this system, we performed validation experiments by applying different palpations (3 and 5 mm) to soft tissue (silicone rubber) and measured reaction forces. In addition, we estimated the elastic moduli of the soft tissue against different palpations and compare the estimated elastic moduli that show similar value even if the palpation depths are different.

Keywords: palpation probe, portable, diabetic foot ulceration, monitoring, mechanical property

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2917 Epilepsy Seizure Prediction by Effective Connectivity Estimation Using Granger Causality and Directed Transfer Function Analysis of Multi-Channel Electroencephalogram

Authors: Mona Hejazi, Ali Motie Nasrabadi

Abstract:

Epilepsy is a persistent neurological disorder that affects more than 50 million people worldwide. Hence, there is a necessity to introduce an efficient prediction model for making a correct diagnosis of the epileptic seizure and accurate prediction of its type. In this study we consider how the Effective Connectivity (EC) patterns obtained from intracranial Electroencephalographic (EEG) recordings reveal information about the dynamics of the epileptic brain and can be used to predict imminent seizures, as this will enable the patients (and caregivers) to take appropriate precautions. We use this definition because we believe that effective connectivity near seizures begin to change, so we can predict seizures according to this feature. Results are reported on the standard Freiburg EEG dataset which contains data from 21 patients suffering from medically intractable focal epilepsy. Six channels of EEG from each patients are considered and effective connectivity using Directed Transfer Function (DTF) and Granger Causality (GC) methods is estimated. We concentrate on effective connectivity standard deviation over time and feature changes in five brain frequency sub-bands (Alpha, Beta, Theta, Delta, and Gamma) are compared. The performance obtained for the proposed scheme in predicting seizures is: average prediction time is 50 minutes before seizure onset, the maximum sensitivity is approximate ~80% and the false positive rate is 0.33 FP/h. DTF method is more acceptable to predict epileptic seizures and generally we can observe that the greater results are in gamma and beta sub-bands. The research of this paper is significantly helpful for clinical applications, especially for the exploitation of online portable devices.

Keywords: effective connectivity, Granger causality, directed transfer function, epilepsy seizure prediction, EEG

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2916 Mercury Contamination of Wetland Caused by Wastewater from Chlor-Alkali Industry

Authors: Mitsuo Yoshida

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A significant mercury contamination of soil/sediment was unveiled by an environmental monitoring program in a wetland along La Plata River, west to Montevideo City, Uruguay. The mercury contamination was caused by industrial wastewater discharged from a chlor-alkali plant using a mercury-cell process. The contamination level is above 60 mg/kg in soil/sediment. Most of mercury (Hg) in the environment is inorganic, but some fractions are converted by bacteria to methylmercury (MeHg), a toxic organic compound. MeHg biologically accumulates through a food-chain and become serious public health risk. In order to clarify the contaminated part for countermeasure operation, an intervention value of mercury contamination of sediment/soil was defined as 15 mg/kg (total Hg) by the authority. According to the intervention value, mercury contaminated area in the La Plata site is approximately 48,280 m² and estimated total volume of contaminated sediments/soils was around 18,750 m³. The countermeasures to contaminated zone were proposed in two stages; (i) mitigation of risks for public health and (ii) site remediation. The first stage is an installation of fens and net around the contamination zone, for mitigating risks of exposure, inhalation, and intake. The food chain among wetland-river ecosystem was also interrupted by the installation of net and fens. The state of mercury contamination in La Plata site and plan of countermeasure was disclosed to local people and the public, and consensus on setting off-limit area was successfully achieved. Mass media also contribute to share the information on the contamination site. The cost for countermeasures was borne by the industry under the polluter-pay-principle.

Keywords: chlor-alkali plant, mercury contamination, polluter pay principle, Uruguay, wetland

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2915 Inpatient Glycemic Management Strategies and Their Association with Clinical Outcomes in Hospitalized SARS-CoV-2 Patients

Authors: Thao Nguyen, Maximiliano Hyon, Sany Rajagukguk, Anna Melkonyan

Abstract:

Introduction: Type 2 Diabetes is a well-established risk factor for severe SARS-CoV-2 infection. Uncontrolled hyperglycemia in patients with established or newly diagnosed diabetes is associated with poor outcomes, including increased mortality and hospital length of stay. Objectives: Our study aims to compare three different glycemic management strategies and their association with clinical outcomes in patients hospitalized for moderate to severe SARS-CoV-2 infection. Identifying optimal glycemic management strategies will improve the quality of patient care and improve their outcomes. Method: This is a retrospective observational study on patients hospitalized at Adventist Health White Memorial with severe SARS-CoV-2 infection from 11/1/2020 to 02/28/2021. The following inclusion criteria were used: positive SARS-CoV-2 PCR test, age >18 yrs old, diabetes or random glucose >200 mg/dL on admission, oxygen requirement >4L/min, and treatment with glucocorticoids. Our exclusion criteria included: ICU admission within 24 hours, discharge within five days, death within five days, and pregnancy. The patients were divided into three glycemic management groups: Group 1, managed solely by the Primary Team, Group 2, by Pharmacy; and Group 3, by Endocrinologist. Primary outcomes were average glucose on Day 5, change in glucose between Days 3 and 5, and average insulin dose on Day 5 among groups. Secondary outcomes would be upgraded to ICU, inpatient mortality, and hospital length of stay. For statistics, we used IBM® SPSS, version 28, 2022. Results: Most studied patients were Hispanic, older than 60, and obese (BMI >30). It was the first CV-19 surge with the Delta variant in an unvaccinated population. Mortality was markedly high (> 40%) with longer LOS (> 13 days) and a high ICU transfer rate (18%). Most patients had markedly elevated inflammatory markers (CRP, Ferritin, and D-Dimer). These, in combination with glucocorticoids, resulted in severe hyperglycemia that was difficult to control. Average glucose on Day 5 was not significantly different between groups primary vs. pharmacy vs. endocrine (220.5 ± 63.4 vs. 240.9 ± 71.1 vs. 208.6 ± 61.7 ; P = 0.105). Change in glucose from days 3 to 5 was not significantly different between groups but trended towards favoring the endocrinologist group (-26.6±73.6 vs. 3.8±69.5 vs. -32.2±84.1; P= 0.052). TDD insulin was not significantly different between groups but trended towards higher TDD for the endocrinologist group (34.6 ± 26.1 vs. 35.2 ± 26.4 vs. 50.5 ± 50.9; P=0.054). The endocrinologist group used significantly more preprandial insulin compared to other groups (91.7% vs. 39.1% vs. 65.9% ; P < 0.001). The pharmacy used more basal insulin than other groups (95.1% vs. 79.5% vs. 79.2; P = 0.047). There were no differences among groups in the clinical outcomes: LOS, ICU upgrade, or mortality. Multivariate regression analysis controlled for age, sex, BMI, HbA1c level, renal function, liver function, CRP, d-dimer, and ferritin showed no difference in outcomes among groups. Conclusion: Given high-risk factors in our population, despite efforts from the glycemic management teams, it’s unsurprising no differences in clinical outcomes in mortality and length of stay.

Keywords: glycemic management, strategies, hospitalized, SARS-CoV-2, outcomes

Procedia PDF Downloads 438