Search results for: prospective cohort studies
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 12336

Search results for: prospective cohort studies

10566 Time to Second Line Treatment Initiation Among Drug-Resistant Tuberculosis Patients in Nepal

Authors: Shraddha Acharya, Sharad Kumar Sharma, Ratna Bhattarai, Bhagwan Maharjan, Deepak Dahal, Serpahine Kaminsa

Abstract:

Background: Drug-resistant (DR) tuberculosis (TB) continues to be a threat in Nepal, with an estimated 2800 new cases every year. The treatment of DR-TB with second line TB drugs is complex and takes longer time with comparatively lower treatment success rate than drug-susceptible TB. Delay in treatment initiation for DR-TB patients might further result in unfavorable treatment outcomes and increased transmission. This study thus aims to determine median time taken to initiate second-line treatment among Rifampicin Resistant (RR) diagnosed TB patients and to assess the proportion of treatment delays among various type of DR-TB cases. Method: A retrospective cohort study was done using national routine electronic data (DRTB and TB Laboratory Patient Tracking System-DHIS2) on drug resistant tuberculosis patients between January 2020 and December 2022. The time taken for treatment initiation was computed as– days from first diagnosis as RR TB through Xpert MTB/Rif test to enrollment on second-line treatment. The treatment delay (>7 days after diagnosis) was calculated. Results: Among total RR TB cases (N=954) diagnosed via Xpert nationwide, 61.4% were enrolled under shorter-treatment regimen (STR), 33.0% under longer treatment regimen (LTR), 5.1% for Pre-extensively drug resistant TB (Pre-XDR) and 0.4% for Extensively drug resistant TB (XDR) treatment. Among these cases, it was found that the median time from diagnosis to treatment initiation was 6 days (IQR:2-15.8). The median time was 5 days (IQR:2.0-13.3) among STR, 6 days (IQR:3.0-15.0) among LTR, 30 days (IQR:5.5-66.8) among Pre-XDR and 4 days (IQR:2.5-9.0) among XDR TB cases. The overall treatment delay (>7 days after diagnosis) was observed in 42.4% of the patients, among which, cases enrolled under Pre-XDR contributed substantially to treatment delay (72.0%), followed by LTR (43.6%), STR (39.1%) and XDR (33.3%). Conclusion: Timely diagnosis and prompt treatment initiation remain fundamental focus of the National TB program. The findings of the study, however suggest gaps in timeliness of treatment initiation for the drug-resistant TB patients, which could bring adverse treatment outcomes. Moreover, there is an alarming delay in second line treatment initiation for the Pre-XDR TB patients. Therefore, this study generates evidence to identify existing gaps in treatment initiation and highlights need for formulating specific policies and intervention in creating effective linkage between the RR TB diagnosis and enrollment on second line TB treatment with intensified efforts from health providers for follow-ups and expansion of more decentralized, adequate, and accessible diagnostic and treatment services for DR-TB, especially Pre-XDR TB cases, due to the observed long treatment delays.

Keywords: drug-resistant, tuberculosis, treatment initiation, Nepal, treatment delay

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10565 Studies on Lucrative Process Layout for Medium Scale Industries

Authors: Balamurugan Baladhandapani, Ganesh Renganathan, V. R. Sanal Kumar

Abstract:

In this paper a comprehensive review on various factory layouts has been carried out for designing a lucrative process layout for medium scale industries. Industry data base reveals that the end product rejection rate is on the order of 10% amounting large profit loss. In order to avoid these rejection rates and to increase the quality product production an intermediate non-destructive testing facility (INDTF) has been recommended for increasing the overall profit. We observed through detailed case studies that while introducing INDTF to medium scale industries the expensive production process can be avoided to the defective products well before its final shape. Additionally, the defective products identified during the intermediate stage can be effectively utilized for other applications or recycling; thereby the overall wastage of the raw materials can be reduced and profit can be increased. We concluded that the prudent design of a factory layout through critical path method facilitating with INDTF will warrant profitable outcome.

Keywords: intermediate non-destructive testing, medium scale industries, process layout design

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10564 Identifying Biomarker Response Patterns to Vitamin D Supplementation in Type 2 Diabetes Using K-means Clustering: A Meta-Analytic Approach to Glycemic and Lipid Profile Modulation

Authors: Oluwafunmibi Omotayo Fasanya, Augustine Kena Adjei

Abstract:

Background and Aims: This meta-analysis aimed to evaluate the effect of vitamin D supplementation on key metabolic and cardiovascular parameters, such as glycated hemoglobin (HbA1C), fasting blood sugar (FBS), low-density lipoprotein (LDL), high-density lipoprotein (HDL), systolic blood pressure (SBP), and total vitamin D levels in patients with Type 2 diabetes mellitus (T2DM). Methods: A systematic search was performed across databases, including PubMed, Scopus, Embase, Web of Science, Cochrane Library, and ClinicalTrials.gov, from January 1990 to January 2024. A total of 4,177 relevant studies were initially identified. Using an unsupervised K-means clustering algorithm, publications were grouped based on common text features. Maximum entropy classification was then applied to filter studies that matched a pre-identified training set of 139 potentially relevant articles. These selected studies were manually screened for relevance. A parallel manual selection of all initially searched studies was conducted for validation. The final inclusion of studies was based on full-text evaluation, quality assessment, and meta-regression models using random effects. Sensitivity analysis and publication bias assessments were also performed to ensure robustness. Results: The unsupervised K-means clustering algorithm grouped the patients based on their responses to vitamin D supplementation, using key biomarkers such as HbA1C, FBS, LDL, HDL, SBP, and total vitamin D levels. Two primary clusters emerged: one representing patients who experienced significant improvements in these markers and another showing minimal or no change. Patients in the cluster associated with significant improvement exhibited lower HbA1C, FBS, and LDL levels after vitamin D supplementation, while HDL and total vitamin D levels increased. The analysis showed that vitamin D supplementation was particularly effective in reducing HbA1C, FBS, and LDL within this cluster. Furthermore, BMI, weight gain, and disease duration were identified as factors that influenced cluster assignment, with patients having lower BMI and shorter disease duration being more likely to belong to the improvement cluster. Conclusion: The findings of this machine learning-assisted meta-analysis confirm that vitamin D supplementation can significantly improve glycemic control and reduce the risk of cardiovascular complications in T2DM patients. The use of automated screening techniques streamlined the process, ensuring the comprehensive evaluation of a large body of evidence while maintaining the validity of traditional manual review processes.

Keywords: HbA1C, T2DM, SBP, FBS

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10563 Canned Sealless Pumps for Hazardous Applications

Authors: Shuja Alharbi

Abstract:

Oil and Gas industry has many applications considered as toxic or hazardous, where process fluid leakage is not permitted and leads to health, safety, and environmental impacts. Caustic/Acidic applications, High Benzene Concentrations, Hydrogen sulfide rich oil/gas as well as liquids operating above their auto-ignition temperatures are examples of such liquids that pose as a risk to the industry operation, and for those, special arrangements are in place to allow for the safe operation environment. Pumps in the industry requires special attention, specifically in the interface between the fluid and the environment, where the potential of leakages are foreseen. Mechanical Seals are used to contain the fluid within the equipment, but the prices are ever increasing for such seals, along with maintenance, design, and operating requirements. Several alternatives to seals are being employed nowadays, such as Sealless systems, which is hermitically sealed from the atmosphere and does not require sealing. This technology is considered relatively new and requires more studies to understand the limitations and factors associated from an owner and design perspective. Things like financial factors, maintenance factors, and design limitation should be studies further in order to have a mature and reliable technical solution available to end users.

Keywords: pump, sealless, selection, failure

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10562 A Method for Multimedia User Interface Design for Mobile Learning

Authors: Shimaa Nagro, Russell Campion

Abstract:

Mobile devices are becoming ever more widely available, with growing functionality, and are increasingly used as an enabling technology to give students access to educational material anytime and anywhere. However, the design of educational material user interfaces for mobile devices is beset by many unresolved research issues such as those arising from emphasising the information concepts then mapping this information to appropriate media (modelling information then mapping media effectively). This report describes a multimedia user interface design method for mobile learning. The method covers specification of user requirements and information architecture, media selection to represent the information content, design for directing attention to important information, and interaction design to enhance user engagement based on Human-Computer Interaction design strategies (HCI). The method will be evaluated by three different case studies to prove the method is suitable for application to different areas / applications, these are; an application to teach about major computer networking concepts, an application to deliver a history-based topic; (after these case studies have been completed, the method will be revised to remove deficiencies and then used to develop a third case study), an application to teach mathematical principles. At this point, the method will again be revised into its final format. A usability evaluation will be carried out to measure the usefulness and effectiveness of the method. The investigation will combine qualitative and quantitative methods, including interviews and questionnaires for data collection and three case studies for validating the MDMLM method. The researcher has successfully produced the method at this point which is now under validation and testing procedures. From this point forward in the report, the researcher will refer to the method using the MDMLM abbreviation which means Multimedia Design Mobile Learning Method.

Keywords: human-computer interaction, interface design, mobile learning, education

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10561 Association of Daily Physical Activity with Diabetes Control in Patients with Type II Diabetes

Authors: Chia-Hsun Chang

Abstract:

Background: Combination of drug treatment, dietary management, and regular exercise can effectively control type II diabetes mellitus (T2DM). Performing daily physical activities other than structured exercise is much easier and whether daily physical activities including work, walking, housework, gardening, leisure exercise, or transportation have a similar effect on diabetes control is not well studied.Aims and Objectives: This study aims to determine whether daily physical activity undertaken by patients with T2DM is associated with their diabetes control. Design: A correlation study with prospective design. Methods: Purposive sampling of 206 patients with T2DM was recruited from a medical center in Central Taiwan. The International Physical Activity Questionnaire was used to assess daily levels of physical activities, and the Diabetes Compliance Questionnaire was used to assess medication and dietary compliance. Data of diabetes control (hemoglobin A1c, HbA1c)were followed up every three months for one year after recruitment. Results: In this study, the average age of the participants was 62.5 years (±10.4 years), and the average duration of diabetes since diagnosis was 13.2 years (±7.8), 112 of the participants were women (54.4%) and 94 of the participants were men (45.6%). The mean HbA1c level was 7.8% (±1.4), and 78.2% of the participants presented with unsatisfactory diabetes control. Because the participants were distributed across a wide age range, and their physical health, activity levels, and comorbidities might have varied with age, the participants were divided into two groups: 121 participants who were younger than 65 years (58.7%) and 85 participants who were older than 65 years (41.3%). Both younger (< 65 years) and older (> 65 years) patients with diabetes engaged in more moderate and low levels of physical activity (89.3% and 87%, respectively). Results showed that the levels of daily physical activity were not significantly associated with diabetes control after adjustment for medication and dietary compliance in both groups. Conclusion: Performing daily physical activity is not significantly correlated with diabetes control. Daily physical activity cannot completely replace exercise. Relevance to Clinical Practice: Health personnel must encourage patients to engage in exercise that is planned, structured, and repetitive for improving diabetes control.

Keywords: daily physical activity, diabetes control, international physical activity questionnaire (IPAQ), type II diabetes mellitus (T2DM)

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10560 Efficacy of In-Situ Surgical vs. Needle Revision on Late Failed Trabeculectomy Blebs

Authors: Xie Xiaobin, Zhang Yan, Shi Yipeng, Sun Wenying, Chen Shuang, Cai Zhipeng, Zhang Hong, Zhang Lixia, Xie Like

Abstract:

Objective: The objective of this research is to compare the efficacy of the late in-situ surgical revision augmented with continuous infusion and needle revision on failed trabeculectomy blebs. Methods From December 2018 to December 2021, a prospective randomized controlled trial was performed on 44 glaucoma patients with failed bleb ≥ 6months with medically uncontrolled in Eye Hospital, China Academy of Chinese Medical Sciences. They were randomly divided into two groups. 22 eyes of 22 patients underwent the late in-situ surgical revision with continuous anterior chamber infusion in the study group, and 22 of 22 patients were treated with needle revision in the control group. Main outcome measures include preoperative and postoperative intraocular pressure (IOP), the number of anti-glaucoma medicines, the operation success rate, and the postoperative complications. Results The postoperative IOP values decreased significantly from the baseline in both groups (both P<0.05). IOP was significantly lower in the study group than in the control group at one week, 1, and 3 months postoperatively (all P<0.05). IOP reductions in the study group were substantially more prominent than in the control group at all postoperative time points (all P<0.05). The complete success rate in the study group was significantly higher than in the control group (71.4% vs. 33.3%, P<0.05), while the complete failure rate was significantly lower in the study group (0% vs. 28.5%, P<0.05). According to Cox’s proportional hazards regression analysis, high IOP at baseline was independently associated with increased risks of complete failure (adjusted hazard ratio=1.141, 95% confidence interval=1.021-1.276, P<0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05). Conclusion: Both in-situ surgical and needle revision have acceptable success rates and safety for the late failed trabeculectomy blebs, while the former is likely to have a higher level of efficacy over the latter. Needle revision may be insufficient for eyes with low target IOP.

Keywords: glaucoma, trabeculectomy blebs, in-situ surgical revision, needle revision

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10559 Customer Relationship Management - “Is It a Myth or a Reality in Indian Consumer Context”

Authors: Manish Manohar Hingorani

Abstract:

The purpose of the research is to find out the level of understanding, adoption, and implementation of CRM in Indian Businesses, either product/ service and the processes which should be followed to ensure minimal to no customer churn and further enhance loyalty. The study used comprehensive qualitative interviews of 36 respondents across mid and senior-level management in product and services organizations of Indian origin. The findings of the study exhibit a gap between the understanding, adoption and implementation of CRM in the Indian context. Different Industries have attributed different levels of understanding, adoption, and limited implementation studies on CRM to the Indian context exists in different industries, but studies related to the consequences of not understanding the true meaning of CRM at the grass root level and further than on non-adoption and non-implementation will have an adverse effect on the customer loyalty, and customer satisfaction leading to customer churn. As this was a qualitative approach, the analysis was content-based and discourse based. The responses were taken from mid to very-senior management decision-makers in organizations of Indian origin.

Keywords: customer relationship management, Indian consumer, customer loyalty, customer experience, customer satisfaction

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10558 Assess and Improve Building Energy Efficiency– a Case Study on the Office of Research and Graduate Studies at Qatar University

Authors: Mohamed Youssef

Abstract:

The proliferation of energy consumption in the built environment has made energy efficiency and savings strategies a priority objective for energy policies in most countries. Qatar is a clear example, where it has initiated several programs and institutions to mitigate the overuse of electricity consumption and control the energy load of the building by following global standards and spreading awareness campaigns. A Case study on the Office of Research and Graduate Studies at Qatar University has been investigated in this paper. The paper studied the rating load of existing buildings before and after retrofitting by using Carrier’s Hourly Analysis Program (HAP). The performance of the building has increased especially after using the LED light system instead of fluorescent light with a low payback period. GINAN paint and green roof have shown a considerable contribution to the reduction of electrical load in the building. In comparison, the double HR window had the least effect on the reduction of electricity consumption.

Keywords: energy conservation in Qatar, HAP, LED light, GINAN paint, green roof, double HR window

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10557 Exploring Employee Experiences of Distributed Leadership in Consultancy SMEs

Authors: Mohamed Haffar, Ramdane Djebarni, Russell Evans

Abstract:

Despite a growth in literature on distributed leadership, the majority of studies are centred on large public organisations particularly within the health and education sectors. The purpose of this study is to fill the gap in the literature by exploring employee experiences of distributed leadership within two commercial consultancy SME businesses in the UK and USA. The aim of the study informed an exploratory method of research to gather qualitative data drawn from semi-structured interviews involving a sample of employees in each organisation. A series of broad, open questions were used to explore the employees’ experiences; evidence of distributed leadership; and extant barriers and practices in each organisation. Whilst some of our findings aligned with patterns and practices in the existing literature, it importantly discovered some emergent themes that have not previously been recognised in the previous studies. Our investigation identified that whilst distributed leadership was in evidence in both organisations, the interviewees’ experience reported that it was sporadic and inconsistent. Moreover, non-client focused projects were reported to be less important and distributed leadership was found to be inconsistent or non-existent.

Keywords: consultancy, distributed leadership, owner-manager, SME, entrepreneur

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10556 Sensory Interventions for Dementia: A Review

Authors: Leigh G. Hayden, Susan E. Shepley, Cristina Passarelli, William Tingo

Abstract:

Introduction: Sensory interventions are popular therapeutic and recreational approaches for people living with all stages of dementia. However, it is unknown which sensory interventions are used to achieve which outcomes across all subtypes of dementia. Methods: To address this gap, we conducted a scoping review of sensory interventions for people living with dementia. We conducted a search of the literature for any article published in English from 1 January 1990 to 1 June 2019, on any sensory or multisensory intervention targeted to people living with any kind of dementia, which reported on patient health outcomes. We did not include complex interventions where only a small aspect was related to sensory stimulation. We searched the databases Medline, CINHAL, and Psych Articles using our institutional discovery layer. We conducted all screening in duplicate to reduce Type 1 and Type 2 errors. The data from all included papers were extracted by one team member, and audited by another, to ensure consistency of extraction and completeness of data. Results: Our initial search captured 7654 articles, and the removal of duplicates (n=5329), those that didn’t pass title and abstract screening (n=1840) and those that didn’t pass full-text screening (n=281) resulted in 174 articles included. The countries with the highest publication in this area were the United States (n=59), the United Kingdom (n=26) and Australia (n=15). The most common type of interventions were music therapy (n=36), multisensory rooms (n=27) and multisensory therapies (n=25). Seven articles were published in the 1990’s, 55 in the 2000’s, and the remainder since 2010 (n=112). Discussion: Multisensory rooms have been present in the literature since the early 1990’s. However, more recently, nature/garden therapy, art therapy, and light therapy have emerged since 2008 in the literature, an indication of the increasingly diverse scholarship in the area. The least popular type of intervention is a traditional food intervention. Taste as a sensory intervention is generally avoided for safety reasons, however it shows potential for increasing quality of life. Agitation, behavior, and mood are common outcomes for all sensory interventions. However, light therapy commonly targets sleep. The majority (n=110) of studies have very small sample sizes (n=20 or less), an indicator of the lack of robust data in the field. Additional small-scale studies of the known sensory interventions will likely do little to advance the field. However, there is a need for multi-armed studies which directly compare sensory interventions, and more studies which investigate the use of layering sensory interventions (for example, adding an aromatherapy component to a lighting intervention). In addition, large scale studies which enroll people at early stages of dementia will help us better understand the potential of sensory and multisensory interventions to slow the progression of the disease.

Keywords: sensory interventions, dementia, scoping review

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10555 Study of the Best Algorithm to Estimate Sunshine Duration from Global Radiation on Horizontal Surface for Tropical Region

Authors: Tovondahiniriko Fanjirindratovo, Olga Ramiarinjanahary, Paulisimone Rasoavonjy

Abstract:

The sunshine duration, which is the sum of all the moments when the solar beam radiation is up to a minimal value, is an important parameter for climatology, tourism, agriculture and solar energy. Its measure is usually given by a pyrheliometer installed on a two-axis solar tracker. Due to the high cost of this device and the availability of global radiation on a horizontal surface, on the other hand, several studies have been done to make a correlation between global radiation and sunshine duration. Most of these studies are fitted for the northern hemisphere using a pyrheliometric database. The aim of the present work is to list and assess all the existing methods and apply them to Reunion Island, a tropical region in the southern hemisphere. Using a database of ten years, global, diffuse and beam radiation for a horizontal surface are employed in order to evaluate the uncertainty of existing algorithms for a tropical region. The methodology is based on indirect comparison because the solar beam radiation is not measured but calculated by the beam radiation on a horizontal surface and the sun elevation angle.

Keywords: Carpentras method, data fitting, global radiation, sunshine duration, Slob and Monna algorithm, step algorithm

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10554 Incidence and Predictors of Mortality Among HIV Positive Children on Art in Public Hospitals of Harer Town, Enrolled From 2011 to 2021

Authors: Getahun Nigusie

Abstract:

Background; antiretroviral treatment reduce HIV-related morbidity, and prolonged survival of patients however, there is lack of up-to-date information concerning the treatment long term effect on the survival of HIV positive children especially in the study area. Objective: To assess incidence and predictors of mortality among HIV positive children on ART in public hospitals of Harer town who were enrolled from 2011 to 2021. Methodology: Institution based retrospective cohort study was conducted among 429 HIV positive children enrolled in ART clinic from January 1st 2011 to December30th 2021. Data were collected from medical cards by using a data extraction form, Descriptive analyses were used to Summarized the results, and life table was used to estimate survival probability at specific point of time after introduction of ART. Kaplan Meier survival curve together with log rank test was used to compare survival between different categories of covariates, and Multivariate Cox-proportional hazard regression model was used to estimate adjusted Hazard rate. Variables with p-values ≤0.25 in bivariable analysis were candidates to the multivariable analysis. Finally, variables with p-values < 0.05 were considered as significant variables. Results: The study participants had followed for a total of 2549.6 child-years (30596 child months) with an overall mortality rate of 1.5 (95% CI: 1.1, 2.04) per 100 child-years. Their median survival time was 112 months (95% CI: 101–117). There were 38 children with unknown outcome, 39 deaths, and 55 children transfer out to different facility. The overall survival at 6, 12, 24, 48 months were 98%, 96%, 95%, 94% respectively. being in WHO clinical Stage four (AHR=4.55, 95% CI:1.36, 15.24), having anemia(AHR=2.56, 95% CI:1.11, 5.93), baseline low absolute CD4 count (AHR=2.95, 95% CI: 1.22, 7.12), stunting (AHR=4.1, 95% CI: 1.11, 15.42), wasting (AHR=4.93, 95% CI: 1.31, 18.76), poor adherence to treatment (AHR=3.37, 95% CI: 1.25, 9.11), having TB infection at enrollment (AHR=3.26, 95% CI: 1.25, 8.49),and no history of change their regimen(AHR=7.1, 95% CI: 2.74, 18.24), were independent predictors of death. Conclusion: more than half of death occurs within 2 years. Prevalent tuberculosis, anemia, wasting, and stunting nutritional status, socioeconomic factors, and baseline opportunistic infection were independent predictors of death. Increasing early screening and managing those predictors are required.

Keywords: human immunodeficiency virus-positive children, anti-retroviral therapy, survival, Ethiopia

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10553 Variation of Fertility-Related Traits in Italian Tomato Landraces under Mild Heat Stress

Authors: Maurizio E. Picarella, Ludovica Fumelli, Francesca Siligato, Andrea Mazzucato

Abstract:

Studies on reproductive dynamics in crops subjected to heat stress are crucial to breed more tolerant cultivars. In tomato, cultivars, breeding lines, and wild species have been thoroughly evaluated for the response to heat stress in several studies. Here, we address the reaction to temperature stress in a panel of selected landraces representing genotypes cultivated before the advent of professional varieties that usually show high adaptation to local environments. We adopted an experimental design with two open field trials, where transplanting was spaced by one month. In the second field, plants were thus subjected to mild stress with natural temperature fluctuations. The genotypes showed wide variation for both vegetative (plant height) and reproductive (stigma exsertion, pollen viability, number of flowers per inflorescence, and fruit set) traits. On average, all traits were affected by heat conditions; except for the number of flowers per inflorescence, the “G*E” interaction was always significant. In agreement with studies based on different materials, estimated broad sense heritability was high for plant height, stigma exsertion, and pollen viability and low for the number of flowers per inflorescence and fruit set. Despite the interaction, traits recorded in control and in heat conditions were positively correlated. The first two principal components estimated by multivariate analysis explained more than 50% of the total variability. The study indicated that landraces present a wide variability for the response of reproductive traits to temperature stress and that such variability could be very informative to dissect the traits with higher heritability and identify new QTL useful for breeding more resilient varieties.

Keywords: fruit set, heat stress, solanum lycopersicum L., style exsertion, tomato

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10552 Sustainable Community Education: Strategies for Long-Term Impact

Authors: Kariman Abdelaziz Ahmed Ali Hamzawy

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Amidst the growing global challenges facing communities, from climate change to educational gaps, sustainable community education has emerged as a vital tool for ensuring comprehensive and enduring development. This research aims to explore effective strategies for sustainable community education that can lead to long-term impacts on local communities. The study begins by defining the concept of sustainable education within a community context and reviews the current literature on the topic. It then presents case studies from various communities around the world where sustainable educational strategies have been successfully implemented. These case studies illustrate how sustainable education can enhance community engagement, build local capacities, and improve quality of life in sustainable ways. The findings from these studies are analyzed to identify the key factors contributing to the success of sustainable educational programs. These factors include partnerships between different sectors (governmental, private, and community), the innovative use of technology, and the adaptation of educational curricula to meet the unique needs of the community. The research also offers practical recommendations on designing and implementing sustainable educational programs, emphasizing the integration of formal and informal education, promoting lifelong learning, and developing local resources. It addresses potential challenges and ways to overcome them to ensure the long-term sustainability of these programs. In conclusion, the research provides a future vision of the role of sustainable education in building resilient and prosperous communities and highlights the importance of investing in education as a key driver of sustainable development. This study contributes to the ongoing discussion on achieving lasting impact through sustainable community education and offers a practical framework for stakeholders to adopt and implement these strategies.

Keywords: sustainable education, community education, Community engagement, local capacity building, educational technology

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10551 Expression of Micro-RNA268 in Zinc Deficient Rice

Authors: Sobia Shafqat, Saeed Ahmad Qaisrani

Abstract:

MicroRNAs play an essential role in the regulation and development of all processes in most eukaryotes because of their prospective part as mediators controlling cell growth and differentiation towards the exact position of RNAs response in plants under biotic and abiotic factors or stressors. In a few cases, Zn is oblivious poisonous for plants due to its heavy metal status. Some other metals are extremely toxic, like Cd, Hg, and Pb, but these elements require in rice for the programming of genes under abiotic stress resembling Zn stress when micro RNAs268 was importantly introduced in rice. The micro RNAs overexpressed in transgenic plants with an accumulation of a large amount of melanin dialdehyde, hydrogen peroxide, and an excessive quantity of Zn in the seedlings stage. Let out results for rice pliability under Zn stress micro RNAs act as negative controllers. But the role of micro RNA268 act as a modulator in different ecological condition. It has been explained clearly with a long understanding of the role of micro RNA268 under stress conditions; pliability and practically showed outcome to increase plant sufferance under Zn stress because micro RNAs is an intervention technique for gene regulation in gene expression. The proposed study was experimented with by using genetic factors of Zn stress and toxicity effect on rice plants done at District Vehari, Pakistan. The trial was performed randomly with three replications in a complete block design (RCBD). These blocks were controlled with different concentrations of genetic factors. By overexpression of micro RNA268 rice, seedling growth was not stopped under Zn deficiency due to the accumulation of a large amount of melanin dialdehyde, hydrogen peroxide, and an excessive quantity of Zn in their seedlings. Results showed that micro RNA268 act as a negative controller under Zn stress. In the end, under stress conditions, micro RNA268 showed the necessary function in the tolerance of rice plants. The directorial work sketch gave out high agronomic applications and yield outcomes in rice with a specific amount of Zn application.

Keywords: micro RNA268, zinc, rice, agronomic approach

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10550 Proposed Algorithms to Assess Concussion Potential in Rear-End Motor Vehicle Collisions: A Meta-Analysis

Authors: Rami Hashish, Manon Limousis-Gayda, Caitlin McCleery

Abstract:

Introduction: Mild traumatic brain injuries, also referred to as concussions, represent an increasing burden to society. Due to limited objective diagnostic measures, concussions are diagnosed by assessing subjective symptoms, often leading to disputes to their presence. Common biomechanical measures associated with concussion are high linear and/or angular acceleration to the head. With regards to linear acceleration, approximately 80g’s has previously been shown to equate with a 50% probability of concussion. Motor vehicle collisions (MVCs) are a leading cause of concussion, due to high head accelerations experienced. The change in velocity (delta-V) of a vehicle in an MVC is an established metric for impact severity. As acceleration is the rate of delta-V with respect to time, the purpose of this paper is to determine the relation between delta-V (and occupant parameters) with linear head acceleration. Methods: A meta-analysis was conducted for manuscripts collected using the following keywords: head acceleration, concussion, brain injury, head kinematics, delta-V, change in velocity, motor vehicle collision, and rear-end. Ultimately, 280 studies were surveyed, 14 of which fulfilled the inclusion criteria as studies investigating the human response to impacts, reporting head acceleration, and delta-V of the occupant’s vehicle. Statistical analysis was conducted with SPSS and R. The best fit line analysis allowed for an initial understanding of the relation between head acceleration and delta-V. To further investigate the effect of occupant parameters on head acceleration, a quadratic model and a full linear mixed model was developed. Results: From the 14 selected studies, 139 crashes were analyzed with head accelerations and delta-V values ranging from 0.6 to 17.2g and 1.3 to 11.1 km/h, respectively. Initial analysis indicated that the best line of fit (Model 1) was defined as Head Acceleration = 0.465

Keywords: acceleration, brain injury, change in velocity, Delta-V, TBI

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10549 Value Creation of My Health Bank of National Health Insurance: Service Dominant Logic Perspective

Authors: Yu Hua Yan

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Background: This research attempts to extend and apply the concept of service dominant logic on My Health Bank platform, analyzed to find out are there any significant difference in wills to participate (potential factors for value) on the results of value co-creation? Methods: The questionnaires were delivered from August 2017 to October 2017 in hospitals. 167 valid ones were received, with an effective response rate of 98.2%. Results: This research employed the questionnaire method in collecting research data, with patients that have used My Health Bank as objects, to whom questionnaires were sent. Regarding the factors influencing therapeutic effects, in the statistics of capability and interaction, it reached a significant level (p <0.1). Regarding the factors influencing satisfaction on medical service, in the statistics of capability and interaction, it reached a significant level (p <0.001). Conclusion: Regarding the contributions of this research, it is possible to clarify its contents with the studies on value co-creation to enrich the literature of the studies of service dominant logic and value co-creation in Taiwan. Regarding its contribution in practice, the results of this research allows the value advocator – the government, to have a broader view in the consideration of making the policies on value co-creation.

Keywords: My Health Bank, interactive, participation, value creation

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10548 Comparative Isotherms Studies on Adsorptive Removal of Methyl Orange from Wastewater by Watermelon Rinds and Neem-Tree Leaves

Authors: Sadiq Sani, Muhammad B. Ibrahim

Abstract:

Watermelon rinds powder (WRP) and neem-tree leaves powder (NLP) were used as adsorbents for equilibrium adsorption isotherms studies for detoxification of methyl orange dye (MO) from simulated wastewater. The applicability of the process to various isotherm models was tested. All isotherms from the experimental data showed excellent linear reliability (R2: 0.9487-0.9992) but adsorptions onto WRP were more reliable (R2: 0.9724-0.9992) than onto NLP (R2: 0.9487-0.9989) except for Temkin’s Isotherm where reliability was better onto NLP (R2: 0.9937) than onto WRP (R2: 0.9935). Dubinin-Radushkevich’s monolayer adsorption capacities for both WRP and NLP (qD: 20.72 mg/g, 23.09 mg/g) were better than Langmuir’s (qm: 18.62 mg/g, 21.23 mg/g) with both capacities higher for adsorption onto NLP (qD: 23.09 mg/g; qm: 21.23 mg/g) than onto WRP (qD: 20.72 mg/g; qm: 18.62 mg/g). While values for Langmuir’s separation factor (RL) for both adsorbents suggested unfavourable adsorption processes (RL: -0.0461, -0.0250), Freundlich constant (nF) indicated favourable process onto both WRP (nF: 3.78) and NLP (nF: 5.47). Adsorption onto NLP had higher Dubinin-Radushkevich’s mean free energy of adsorption (E: 0.13 kJ/mol) than WRP (E: 0.08 kJ/mol) and Temkin’s heat of adsorption (bT) was better onto NLP (bT: -0.54 kJ/mol) than onto WRP (bT: -0.95 kJ/mol) all of which suggested physical adsorption.

Keywords: adsorption isotherms, methyl orange, neem leaves, watermelon rinds

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10547 Polish Operational Plans During Cold War as Part of Warsaw Pact Strategic Culture

Authors: Wiktor Stypczyński

Abstract:

During the Cold War, both sides of the conflict developed advanced operational plans in case of a Third World War outbreak. In the Warsaw Pact, Soviet generals in Moscow chose targets for each army, but each country's General Staff had to create specific plans for their nation. This led to the creation of a Strategic Culture within the Warsaw Pact that was reflected in the plans of each army. This paper aims to showcase the Strategic Culture of the Warsaw Pact by using the plans of the People's Polish Army as an example. Examining one army at a time will allow for a more detailed and unique perspective on the matter. Understanding the past Strategic Culture is crucial in comprehending the current post-Soviet strategic situation in Eastern Europe, especially with the current situation in Ukraine. This paper is based on Benon Miśkiewicz's classic methodology of military history. While this methodology is the foundation, the research findings will also draw on the Strategic Studies methodology and the accomplishments of war and military science. Additionally, the Security and Political Studies methodology will be a crucial element in constructing the narrative.

Keywords: cold war, operetional plans, strategic culture, polish people's army

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10546 Observations of Conformity in the Health Professions

Authors: Tanya Beran, Michelle Drefs, Ghazwan Altabbaa, Nouf Al Harbi, Noof Al Baz, Elizabeth Oddone Paolucci

Abstract:

Although research shows that interprofessional practice has desirable effects on patient care, its implementation can present challenges to its team members. In particular, they may feel pressured to agree with or conform to other members who share information that is contrary to their own understanding. Obtaining evidence of this phenomenon is challenging, as team members may underreport their conformity behaviors due to reasons such as social desirability. In this paper, a series of studies are reviewed in which several approaches to assessing conformity in the health care professions are tested. Simulations, questionnaires, and behavior checklists were developed to measure conformity behaviors. Insights from these studies show that a significant proportion of people conform either in the presence or absence of others, express a variety of verbal and nonverbal behaviors when considering whether to conform to others, may shift between conforming and moments later not conforming (and vice versa), and may not accurately report whether they conformed. A new method of measuring conformity using the implicit bias test is also discussed. People at all levels in the healthcare system are encouraged to develop both formal and informal.

Keywords: conformity, decision-making, inter-professional teams, simulation

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10545 Signed Language Phonological Awareness: Building Deaf Children's Vocabulary in Signed and Written Language

Authors: Lynn Mcquarrie, Charlotte Enns

Abstract:

The goal of this project was to develop a visually-based, signed language phonological awareness training program and to pilot the intervention with signing deaf children (ages 6 -10 years/ grades 1 - 4) who were beginning readers to assess the effects of systematic explicit American Sign Language (ASL) phonological instruction on both ASL vocabulary and English print vocabulary learning. Growing evidence that signing learners utilize visually-based signed language phonological knowledge (homologous to the sound-based phonological level of spoken language processing) when reading underscore the critical need for further research on the innovation of reading instructional practices for visual language learners. Multiple single-case studies using a multiple probe design across content (i.e., sign and print targets incorporating specific ASL phonological parameters – handshapes) was implemented to examine if a functional relationship existed between instruction and acquisition of these skills. The results indicated that for all cases, representing a variety of language abilities, the visually-based phonological teaching approach was exceptionally powerful in helping children to build their sign and print vocabularies. Although intervention/teaching studies have been essential in testing hypotheses about spoken language phonological processes supporting non-deaf children’s reading development, there are no parallel intervention/teaching studies exploring hypotheses about signed language phonological processes in supporting deaf children’s reading development. This study begins to provide the needed evidence to pursue innovative teaching strategies that incorporate the strengths of visual learners.

Keywords: American sign language phonological awareness, dual language strategies, vocabulary learning, word reading

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10544 Evaluation of Traumatic Spine by Magnetic Resonance Imaging

Authors: Sarita Magu, Deepak Singh

Abstract:

Study Design: This prospective study was conducted at the department of Radio Diagnosis, at Pt B.D. Sharma PGIMS, Rohtak in 57 patients of spine injury on radiographs or radiographically normal patients with neurological deficits presenting within 72 hours of injury. Aims: Evaluation of the role of Magnetic Resonance Imaging (MRI) in Spinal Trauma Patients and to compare MRI findings with clinical profile and neurological status of the patient and to correlate the MRI findings with neurological recovery of the patient and predict the outcome. Material and Methods: Neurological status of patients was assessed at the time of admission and discharge in all the patients and at long term interval of six months to one year in 27 patients as per American spine injury association classification (ASIA). On MRI cord injury was categorized into cord hemorrhage, cord contusion, cord edema only, and normal cord. Quantitative assessment of injury on MRI was done using mean canal compromise (MCC), mean spinal cord compression (MSCC) and lesion length. Neurological status at admission and neurological recovery at discharge and long term follow up was compared with various qualitative cord findings and quantitative parameters on MRI. Results: Cord edema and normal cord was associated with favorable neurological outcome. Cord contusion show lesser neurological recovery as compared to cord edema. Cord hemorrhage was associated with worst neurological status at admission and poor neurological recovery. Mean MCC, MSCC, and lesion length values were higher in patients presenting with ASIA A grade injury and showed decreasing trends towards ASIA E grade injury. Patients showing neurological recovery over the period of hospital stay and long term follow up had lower mean MCC, MSCC, and lesion length as compared to patients showing no neurological recovery. The data was statistically significant with p value <.05. Conclusion: Cord hemorrhage and higher MCC, MSCC and lesion length has poor prognostic value in spine injury patients.

Keywords: spine injury, cord hemorrhage, cord contusion, MCC, MSCC, lesion length, ASIA grading

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10543 The Effect of Diet Intervention for Breast Cancer: A Meta-Analysis

Authors: Bok Yae Chung, Eun Hee Oh

Abstract:

Breast cancer patients require more nutritional interventions than others. However, a few studies have attempted to assess the overall nutritional status, to reduce body weight and BMI by improving diet, and to improve the prognosis of cancer for breast cancer patients. The purpose of this study was to evaluate the effect of diet intervention in the breast cancer patients through meta-analysis. For the study purpose, 16 studies were selected by using PubMed, ScienceDirect, ProQuest and CINAHL. Meta-analysis was performed using a random-effects model, and the effect size on outcome variables in breast cancer was calculated. The effect size for outcome variables of diet intervention was a large effect size. For heterogeneity, moderator analysis was performed using intervention type and intervention duration. All moderators did not significant difference. Diet intervention has significant positive effects on outcome variables in breast cancer. As a result, it is suggested that the timing of the intervention should be no more than six months, but a strategy for sustaining long-term intervention effects should be added if nutritional intervention is to be administered for breast cancer patients in the future.

Keywords: breast cancer, diet, mete-analysis, intervention

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10542 Ultrasound as an Aid to Predict the Onset of Leaking in Dengue Haemorrhagic Fever: Experience of a Dengue Treatment Facility in South Asia

Authors: Hasn Perera, Is Almeida, Hnk Perera, Mzf Mohammed, Ade Silva, H. Wijesinghe, Ajal Fernando

Abstract:

Introduction: Dengue is a major Public Health burden of two clinical entities, Dengue Fever & Dengue Haemorrhagic Fever (DHF). The vast majority of dengue deaths occur in DHF patients, where the diagnosis hinges on the presence of fluid leakage. Limited Ultrasound Scans (USS) of chest and abdomen are used widely at Centre for Clinical Management of Dengue & Dengue Haemorrhagic Fever (CCMDDHF), as the primary method for detecting fluid leaking in DHF. This study analyses the relationship between haematological and USS findings at the onset of leaking and to further determine the usefulness of ultrasound in diagnosing DHF. Methods: A prospective analysis of 80 serologically confirmed dengue patients initially admitted to a General Medical and Paediatric wards who were subsequently transferred to the CCMDDHF from March to September 2017 were analysed. In addition to repeated blood counts and capillary haematocrits’, serial USS were done to detect the onset fluid leaking by three competent and experienced doctors at CCMDDHF. Results: 80 patients (male: female: 38:42) with a mean age of 20 years (SD ±16.8, range 3-74) were evaluated. Dropping of platelet counts below 100,000 and haematocrit rise towards 20% started 4±1.3 day of fever with a mean platelet value of 69x103(range17-98x103). Gallbladder wall thickening was the commonest (98.7%) USS finding followed by fluid in hepato-renal pouch (95%), pelvic fluid (58.7%), right-sided pleural effusion (35%), bilateral effusions (7.5%). USS evidence of plasma leakage was detected in 11.25 %( n=9) of DHF cases from 1 day before significant haematocrit rise was noted. 35 (43.7%) patients with lowering platelets and haematocrit rise showed no objective evidence of plasma leaking on ultrasound scan. Conclusion: This outbreak underscores the importance of USS as a useful, sensitive and cost-effective tool for early diagnosis of suspected DHF cases, facilitating the tracking of progress of leaking and management of epidemics.

Keywords: dengue, ultrasound, plasma leaking, South Asia

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10541 Toward Automatic Chest CT Image Segmentation

Authors: Angely Sim Jia Wun, Sasa Arsovski

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Numerous studies have been conducted on the segmentation of medical images. Segmenting the lungs is one of the common research topics in those studies. Our research stemmed from the lack of solutions for automatic bone, airway, and vessel segmentation, despite the existence of multiple lung segmentation techniques. Consequently, currently, available software tools used for medical image segmentation do not provide automatic lung, bone, airway, and vessel segmentation. This paper presents segmentation techniques along with an interactive software tool architecture for segmenting bone, lung, airway, and vessel tissues. Additionally, we propose a method for creating binary masks from automatically generated segments. The key contribution of our approach is the technique for automatic image thresholding using adjustable Hounsfield values and binary mask extraction. Generated binary masks can be successfully used as a training dataset for deep-learning solutions in medical image segmentation. In this paper, we also examine the current software tools used for medical image segmentation, discuss our approach, and identify its advantages.

Keywords: lung segmentation, binary masks, U-Net, medical software tools

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10540 Historical Studies on Gilt Decorations on Glazed Surfaces

Authors: Sabra Saeidi

Abstract:

This research focuses on the historical techniques associated with the lajevardina and Haft-Rangi production methods in creating tiles, with emphasis on the identification of the techniques of inserting gold sheets on the surface of such historical glazed tiles. In this regard, firstly, the history of the production of enamel, gold plated, and Lajevardina glazed pottery work made during the Khwarizmanshahid and Mongol era (eleventh to the thirteenth century) have been assessed to reach a better understanding of the background and the history associated with historical glazing methods. After the historical overview of the production technique of glazed pottery work and introductions of the civilizations using those techniques, we focused on the niches production methods of enamel and Lajevardina glazing, which are two categories of decorations usually found in tiles. Next, a general classification method for various types of gilt tiles has been introduced, which is applicable to the tile works up to Safavid period (Sixteenth to the seventeenth century). Gilded lajevardina glazed tiles, gilt Haft-Rangi tiles, monolithic glazed gilt tiles, and gilt mosaic tiles are included in the categories.

Keywords: gilt tiles, Islamic art, Iranian art, historical studies, gilding

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10539 Information Communication Technology in Early Childhood Education: An Assessment of the Quality of ICT in the New Mega Primary Schools in Ondo State, Southwestern Nigeria

Authors: Oluyemi Christianah Ojo

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This study seeks to investigate the quality of ICT provided in the new Caring Heart schools in Ondo State, Nigeria. The population for the study was all caring Heart Mega Schools in Ondo State, Nigeria. Research questions were generated; two instruments CCCMS and TQCUC were used to elicit information from the schools and the teachers. The study adopts descriptive survey approach. The studies revealed and concluded that ICT components were available and adequate in these schools, Charts showing ICT components and other forms of computer devices used as instructional materials were available but were not adequate; teachers teaching computer studies are competent in the delivery of instructions and in handling computer gadgets in the laboratory. The study recommended the provision of steady electricity, uninterrupted internet facilities and provision of adequate ICT components and charts for effective teaching delivery and learning.

Keywords: facilities, information communication technology, mega primary school, primary education

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10538 Enhance Engineering Pedagogy in Programming Course via Knowledge Graph-Based Recommender System

Authors: Yan Li

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Purpose: There is a lack of suitable recommendation systems to assist engineering teaching. The existing traditional engineering pedagogies lack learning interests for postgraduate students. The knowledge graph-based recommender system aims to enhance postgraduate students’ programming skills, with a focus on programming courses. Design/methodology/approach: The case study will be used as a major research method, and the two case studies will be taken in both two teaching styles of the universities (Zhejiang University and the University of Nottingham Ningbo China), followed by the interviews. Quantitative and qualitative research methods will be combined in this study. Research limitations/implications: The case studies were only focused on two teaching styles universities, which is not comprehensive enough. The subject was limited to postgraduate students. Originality/value: The study collected and analyzed the data from two teaching styles of universities’ perspectives. It explored the challenges of Engineering education and tried to seek potential enhancement.

Keywords: knowledge graph and recommender system, engineering pedagogy, programming skills, postgraduate students

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10537 Armenian Refugees in Early 20th C Japan: Quantitative Analysis on Their Number Based on Japanese Historical Data with the Comparison of a Foreign Historical Data

Authors: Meline Mesropyan

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At the beginning of the 20th century, Japan served as a transit point for Armenian refugees fleeing the 1915 Genocide. However, research on Armenian refugees in Japan is sparse, and the Armenian Diaspora has never taken root in Japan. Consequently, Japan has not been considered a relevant research site for studying Armenian refugees. The primary objective of this study is to shed light on the number of Armenian refugees who passed through Japan between 1915 and 1930. Quantitative analyses will be conducted based on newly uncovered Japanese archival documents. Subsequently, the Japanese data will be compared to American immigration data to estimate the potential number of refugees in Japan during that period. This under-researched area is relevant to both the Armenian Diaspora and refugee studies in Japan. By clarifying the number of refugees, this study aims to enhance understanding of Japan's treatment of refugees and the extent of humanitarian efforts conducted by organizations and individuals in Japan, contributing to the broader field of historical refugee studies.

Keywords: Armenian genocide, Armenian refugees, Japanese statistics, number of refugees

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