Search results for: Patient-related outcomes

Authors: R. Hassan, J. Duncombe, E. Darke, A. Dias, K. Anderson, R. G. Middleton

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NHS England has set itself the task of delivering a “Net Zero” National Health service by 2040. It is incumbent upon all health care practioners to work towards this goal. Orthopaedic surgeons are no exception. Distal radial fractures are the most common fractures sustained by the adult population. However, studies are shortcoming on individual patient experience. The aim of this study was to assess the patient’s satisfaction and outcomes with woodcast used in the conservative management of distal radius fractures. For all patients managed with woodcast in our unit, we undertook a structured questionnaire that included the Patient Rated Wrist Evaluation (PRWE) score, The EQ-5D-5L score and the pain numerical score at the time of injury and six weeks after. 30 patients were initially managed with woodcast. 80% of patients tolerated woodcast for the full duration of their treatment. Of these, 20% didn’t tolerate woodcast and had their casts removed within 48 hours. Of the remaining, 79.1% were satisfied about woodcast comfort, 66% were very satisfied about woodcast weight, 70% were satisfied with temperature and sweatiness, 62.5% were very satisfied about the smell/odour, and 75% were satisfied about the level of support woodcast provided. During their treatment, 83.3% of patients rated their pain as five or less. For those who completed their treatment in woodcast, none required any further intervention or utilised the open appointment because of ongoing wrist problems. In conclusion, when woodcast is tolerated, patients’ satisfaction and outcome levels were good. However, we acknowledged 20% of patients in our series were not able to tolerate woodacst, Therefore, we suggest a comparison between the widely used synthetic plaster of Paris casting and woodcast to come in order.

Keywords: distal radius fractures, ecological cast, sustainability, woodcast

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Authors: Yao Song, Danni Cheng, Jianjun Ren

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Objectives: We aimed to explore the prognostic effects of absolute values and dynamic changes of common hematological indices on oropharynx squamous cell carcinoma (OPSCC) patients treated with radiation. Methods and materials: The absolute values of white blood cell (WBC), absolute neutrophil count (ANC), absolute lymphocyte count (ALC), hemoglobin (Hb), platelet (Plt), albumin (Alb), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) at baseline (within 45 days before radiation), 1-, 3-, 6- and 12-months after the start of radiotherapy were retrospectively collected. Locally-estimated smoothing scatterplots were used to describe the smooth trajectory of each index. A mixed-effect model with a random slope was fitted to describe the changing rate and trend of indices over time. Cox proportional hazard analysis was conducted to assess the correlation between hematological indices and treatment outcomes. Results: Of the enrolled 85 OPSCC patients, inflammatory indices, such as WBC and ALC, dropped rapidly during acute treatment and gradually recovered, while NLR and PLR increased at first three months and subsequently declined within 3-12 months. Higher absolute value or increasing trend of nutritional indices (Alb and Hb) was associated with better prognosis (all p<0.05). In contrast, patients with higher absolute value or upward trend of inflammatory indices (WBC, ANC, Plt, PLR and NLR) had worse survival (all p<0.05). Conclusions: The absolute values and dynamic changes of hematological indices were valuable prognostic factors for OPSCC patients who underwent radiotherapy.

Keywords: hematological indices, oropharyngeal cancer, radiotherapy, NLR, PLR

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Authors: Jyoti Pandey, Rajiv Kumar Bhatt

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In the absence of proper sanitation, people suffered from high levels of infectious diseases leading to high incidences of morbidity and mortality. This directly affected the ability of a country to maintain an efficient economy and implied great personal suffering among infected individuals and their families. This paper aims to estimate the catastrophic expenditure of households in terms of direct and indirect losses which a person has to face due to the illness of WASH diseases; the severity of the scenario is answered by finding out the impoverishment effect. We used the primary data survey for the objective outlined. Descriptive and analytical research types are used. The survey is done with the questionnaire formulated precisely, taking care of the inclusion of all the variables and probable outcomes. A total of 300 households is covered under this study. In order to pursue the objectives outlined, multistage random sampling of households is used. In this study, the cost of illness approach is followed for accessing economic impact. The study brought out the attention that a significant portion of the total consumption expenditure is going lost for the treatment of water and sanitation related diseases. The infectious and water vector-borne disease can be checked by providing sufficient required sanitation facility, and that 2.02% loss in income can be gained if the mechanisms of the pathogen is checked.

Keywords: water, sanitation, impoverishment, catastrophic expenditure

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Authors: Mohammad Tayefeh Norooz, Amirhossein Kargarzadeh

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Overweight and obesity as an abnormality are health threatening factors. Body mass index (BMI) above 25 is referred to as overweight and above 30 as obese. Apollo Endosurgery, Inc., a pioneering company in endoscopy surgeries, is poised to revolutionize patient care with its minimally invasive treatment options. Some product solutions are designed to improve patient outcomes and redefine the future of healthcare. Weight gain post-weight-loss surgery may stem from an enlarged stomach opening, reducing fullness and increasing food intake. Apollo Endosurgery's OverStitch system, a minimally invasive approach, addresses this by using sutures to reduce stomach opening size. This reflects Apollo's commitment to transformative improvements in healing endoscopy, emphasizing a shift towards minimally invasive options. The system's versatility and precision in full-thickness suturing offer treatment alternatives, exemplified in applications like Endoscopic Sleeve Gastroplasty for reshaping obesity management. Apollo’s dedication to pioneering advancements suggests ongoing breakthroughs in minimally invasive surgery, positioning the OverStitch systems as a testament to innovation in patient care.

Keywords: apollo endosurgery, endoscopic sleeve gastroplasty, weight loss system, overstitch endoscopic suturing system, therapeutic, perforations, fistula

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Authors: Samiah H. Ghounaim

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The topic of this paper is significant because of the increasing need for intercultural training for foreign language teachers due to the continuous challenges they face in their diverse classrooms. First, the structure of the intercultural training program designed will be briefly described, and the structure of a 3D vignette and its intended purposes will be elaborated on. This was the first stage where the program was designed and implemented on the period of three months with a group of local and expatriate foreign language teachers/practitioners at a university in the Middle East. After that, a set of primary data collected during the first stage of this research on the design and co-construction process of a 3D vignette will be reviewed and analysed in depth. Each practitioner designed a personal incident into a 3D vignette where each dimension of the vignette viewed the same incident from a totally different perspective. Finally, the results and the implications of having participant construct their personal incidents into a 3D vignette as a reflective practice will be discussed in detail as well as possible extensions for the research. This process proved itself to be an effective reflective practice where the participants were stimulated to view their incidents in a different light. Co-constructing one’s own critical incidents –be it a positive experience or not– into a structured 3D vignette encouraged participants to decentralise themselves from the incidents and, thus, creating a personal reflective space where they had the opportunity to see different potential outcomes for each incident, as well as prepare for the reflective discussion of their vignette with their peers. This provides implications for future developments in reflective writing practices and possibilities for educators’ continuous professional development (CPD).

Keywords: 3D vignettes, intercultural competence training, reflective practice, teacher training

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Authors: U. Borasi, Amit Kr. Jain, Rakesh, Piyush Jain

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Data collection, data preparation, model training, model evaluation, and deployment are all processes in a typical machine learning workflow. Training data needs to be gathered and organised. This often entails collecting a sizable dataset and cleaning it to remove or correct any inaccurate or missing information. Preparing the data for use in the machine learning model requires pre-processing it after it has been acquired. This often entails actions like scaling or normalising the data, handling outliers, selecting appropriate features, reducing dimensionality, etc. This pre-processed data is then used to train a model on some machine learning algorithm. After the model has been trained, it needs to be assessed by determining metrics like accuracy, precision, and recall, utilising a test dataset. Every time a new model is built, both data pre-processing and model training—two crucial processes in the Machine learning (ML) workflow—must be carried out. Thus, there are various Machine Learning algorithms that can be employed for every single approach to data pre-processing, generating a large set of combinations to choose from. Example: for every method to handle missing values (dropping records, replacing with mean, etc.), for every scaling technique, and for every combination of features selected, a different algorithm can be used. As a result, in order to get the optimum outcomes, these tasks are frequently repeated in different combinations. This paper suggests a simple architecture for organizing this largely produced “combination set of pre-processing steps and algorithms” into an automated workflow which simplifies the task of carrying out all possibilities.

Keywords: machine learning, automation, AUTOML, architecture, operator pool, configuration, scheduler

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Authors: Abhishek Jain, Kavish Kejriwal, V. Balaji Rao, Abhigna Chavda

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Increasing environmental and social concerns are forcing companies to take a fresh view of the impact of supply chain operations on environment and society when designing a supply chain. A challenging task in today’s food industry is the distribution of high-quality food items throughout the food supply chain. Improper storage and unwanted transportation are the major hurdles in food supply chain and can be tackled by making dynamic storage facility location decisions with the distribution network. Since food supply chain in India is one of the biggest supply chains in the world, the companies should also consider environmental impact caused by the supply chain. This project proposes a multi-objective optimization model by integrating sustainability in decision-making, on distribution in a food supply chain network (SCN). A Multi-Objective Mixed-Integer Linear Programming (MOMILP) model between overall cost and environmental impact caused by the SCN is formulated for the problem. The goal of MOMILP is to determine the pareto solutions for overall cost and environmental impact caused by the supply chain. This is solved by using GAMS with CPLEX as third party solver. The outcomes of the project are pareto solutions for overall cost and environmental impact, facilities to be operated and the amount to be transferred to each warehouse during the time horizon.

Keywords: multi-objective mixed linear programming, food supply chain network, GAMS, multi-product, multi-period, environment

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Authors: Jutamas Wisansing, Thanakarn Vongvisitsin, Udom Hongchatikul

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Food could be used to open up a dialogue about local heritage. Contributing to the world sustainable consumption mission, this research aims to explore the linkages between agriculture, senses of place and performing arts. Thailand and its destination marketing ‘Discover Thainess’ was selected as a working principle, enabling a case example of how the three elements could be conceptualized. The model offered an integrated institutional arrangement where diverse entities could be formed to design how Thainess (local heritage) could be interpreted and embedded into an art of food. Using case study research approach, three areas (Chiangmai, Samutsongkram and Ban Rai Gong King) representing 3 different scales of tourism development were selected. Based on a theoretical analysis, a working model was formulated. An action research was then designed to experiment how the model could be materialized. Brainstorming elicitation and in-depth interview were employed to reflect on how each element could be integrated. The result of this study offered an innovation on how food tourism could be profoundly interpreted and how tourism development could enhance value creation for agricultural based community. The outcomes of the research present co-creative multi-stakeholder model and the value creation method through the whole supply chain of Thai gastronomy. The findings have been eventually incorporated into ‘gastro-diplomacy’ strategy for Thai tourism.

Keywords: community-based tourism, gastro-diplomacy, gastronomy tourism, sustainable tourism development

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Authors: Anshul, Rajni Kalia, Sachin Kumar

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Introduction: The costoclavicular approach, a modification to the infraclavicular approach, has been described for anesthesia for upper limb surgeries. Material And Methods: In this randomized and single-blind study, fourty patients undergoing emergency/elective upper limb surgery were allocated to two groups. Group C and S received ultrasound-guided Costoclavicular block and Supraclavicular block, respectively, with 20 ml 0.5 % ropivacaine with 8 mg dexamethasone under strict asepsis. The primary outcome assessed was the total duration of sensory and motor block in the postoperative period. Secondary outcomes were to compare the time taken to perform the procedure, block characteristics in terms of onset of motor and sensory blockade, the efficacy of analgesia with respect to the time of administration of the first rescue analgesic dose with both the blocks and note the side effects pertaining to either of the blocks. Results: The mean total duration of sensory and motor blockade was longer in group C vs. group S (p=0.002 and 0.024, respectively). The mean duration to perform a block in group S was more than in group C (p=0.012). The mean onset of sensory and motor Blockade Time in group S was more than in group C (p<0.001 and <0.001, respectively). The mean duration to perform a block in group S was more than in group C (p=0.012). Conclusion: The costoclavicular approach is better than supraclavicular in terms of rapid execution, faster onset of sensory-motor blockade, prolonged postoperative analgesia and similar PONV and safety profile.

Keywords: costoclavicular, supraclavicular, ropivacaine, dexamethasone

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Authors: Swati Srivastava, Ashish Kumar Upadhyay

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Haemophilus influenzae Type B (Hib) cause infections of pneumonia, meningitis, epiglottises and other invasive disease exclusively among children under age five. Occurrence of these infections may impair child growth by causing micronutrient deficiency. Using longitudinal data from first and second waves of Young Lives Study conducted in India during 2002 and 2006-07 respectively and multivariable logistic regression models (using generalised estimation equation to take into account the cluster nature of sample), this study aims to examine the impact of Hib vaccination on child anthropometric outcomes (stunting, underweight and wasting) in India. Bivariate result shows that, a higher percent of children were stunted and underweight among those who were not vaccinated against Hib (39% & 48% respectively) as compare to those who were vaccinated (31% and 39% respectively).The risk of childhood stunting and underweight was significantly lower among children who were vaccinated against Hib (odds ratio: 0.77, 95% CI: 0.62-0.96 and odds ratio: 0.79, 95% C.I: 0.64-0.98 respectively) as compare to the unvaccinated children. No significant association was found between vaccination status against Hib and childhood wasting. Moreover, in the statistical models, about 13% of stunting and 12% of underweight could be attributable to lack of vaccination against Hib in India. Study concludes that vaccination against Hib- in addition to being a major intervention for reducing childhood infectious disease and mortality- can be consider as a potential tool for reducing the burden of undernutrition in India. Therefore, the Government of India must include the vaccine against Hib into the Universal Immunization Programme in India.

Keywords: Haemophilus influenzae Type-B, Stunting, Underweight, Wasting, Young Lives Study (YLS), India

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Authors: Awais Naeem, Osama Shakeel, Faizan Ullah, Abdul Wahid Anwer

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Introduction: To study the clinic-pathological factors, diagnostic factors and survival of extra-pulmonary small cell carcinoma. Methodology: From 1995 to 2017 all patients with a diagnosis of extra-pulmonary small cell carcinoma were included in the study. Demographic variables and clinic-pathological factors were collected. Management of disease was recorded. Short and long term oncological outcomes were recorded. All data was entered and analyzed in SPSS version 21. Results: A total of 14 patients were included in the study. Median age was 53.42 +/- 16.1 years. There were 5 male and 9 female patients. Most common presentation was dysphagia in 16 patient among esophageal small cell carcinoma and while other patient had pain in abdomen. Mean duration of symptoms was 4.23+/-2.91 months .Most common site is esophagus (n=6) followed by gall bladder(n=3). Almost all of the patients received chemo-radiotherapy. Majority of the patient presented with extensive disease. Five patients (35.7%) died during the follow up period, two (14.3%) were alive and rest of the patients were lost to follow up. Mean follow up period was 22.92 months and median follow up was 15 months. Conclusion: Extra-pulmonary small cell carcinoma is rare and needs to be managed aggressively. All patients should be treated with both systemic and local therapies.

Keywords: small cell carcinoma of esophagus, extrapulmonary small cell carcinoma, small cell carcinoma of gall bladder, small cell carcinoma of rectum, small cell carcinoma of stomach

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Authors: Eslam Dabbish, Fortuna Ponte, Stefano Scoditti, Emilia Sicilia, Gloria Mazzone

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The medical techniques based on the use of light for activating the drug are occupying a prominent place in the cancer treatment due to their selectivity that contributes to reduce undesirable side effects of conventional chemotherapy. Among these therapeutic treatments, photodynamic therapy (PDT) and photoactivated chemotherapy (PACT) are emerging as complementary approaches for selective destruction of neoplastic tissue through direct cellular damage. Both techniques rely on the employment of a molecule, photosensitizer (PS), able to absorb within the so-called therapeutic window. Thus, the exposure to light of otherwise inert molecules promotes the population of excited states of the drug, that in PDT are able to produce the cytotoxic species, such as 1O2 and other ROS, in PACT can be responsible of the active species release or formation. Following the success of cisplatin in conventional treatments, many other transition metal complexes were explored as anticancer agents for applications in different medical approaches, including PDT and PACT, in order to improve their chemical, biological and photophysical properties. In this field, several crucial characteristics of candidate PSs can be accurately predicted from first principle calculations, especially in the framework of density functional theory and its time-dependent formulation, contributing to the understanding of the entire photochemical pathways involved which can ultimately help in improving the efficiency of a drug. A brief overview of the outcomes on some platinum and ruthenium-based PSs proposed for the application in the two phototherapies will be provided.

Keywords: TDDFT, metal complexes, PACT, PDT

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Authors: M. C. Venter, G. Hitge, S. C. Krygsman, J. Thiart

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For decades, South Africa has been planning transportation systems from a supply, rather than a demand side, perspective. In terms of parking, this relates to requiring the minimum parking provision that is enforced by city officials. Newer insight is starting to indicate that South Africa needs to re-think this philosophy in light of a new policy environment that desires a different outcome. Urban policies have shifted from reliance on the private car for access, to employing a wide range of alternative modes. Car dominated travel is influenced by various parameters, of which the availability and location of parking plays a significant role. The question is therefore, what is the right strategy to achieve the desired transport outcomes for SA. The focus of this paper is used to assess this issue with regard to parking provision, and specifically at a tertiary institution. A parking audit was conducted at the Stellenbosch campus of Stellenbosch University, monitoring occupancy at all 60 parking areas, every hour during business hours over a five-day period. The data from this survey was compared with the prescribed number of parking bays according to the Stellenbosch Municipality zoning scheme (requiring a minimum of 0.4 bays per student). The analysis shows that by providing 0.09 bays per student, the maximum total daily occupation of all the parking areas did not exceed an 80% occupation rate. It is concluded that the prevailing parking standards are not supportive of the new urban and transport policy environment, but that it is extremely conservative from a practical demand point of view.

Keywords: parking provision, parking requirements, travel behaviour, travel demand management

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Authors: Youmen Chaaban

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The study examined the influence of a situated professional development program (PD) aimed at enhancing English language teachers’ knowledge and skills and improving their instructional practices. The PD model under examination was developed upon sound theoretical underpinnings, taking into consideration research-based principles of effective PD. However, the implementation of the PD model within several school contexts required further investigation from the perspectives of the teachers, who were receiving the PD activities, and the instructional coaches, who were providing them. The paper, thus, presents the results of a qualitative study examining the perceptions of seventeen English language teachers and nineteen instructional coaches about the strengths of the PD program, the challenges they faced in the implementation of the program, and their suggestions for the improvement of the program’s implementation and outcomes. Comparisons were further made between the two groups of participants to uncover agreements and contradictions in their perceptions. Data were collected from the teachers through in-depth interviews and observations, while the data collected from the instructional coaches were open-ended surveys followed by focus group interviews. The findings of the study confirm the necessity of structuring PD activities around sound theoretical underpinnings. However, practical considerations specific to the contexts where the PD activities take place should be considered when evaluating the PD’s effectiveness. Finally, the study provides several recommendations for maximizing the influence of the PD program on teachers’ practices and beliefs.

Keywords: English language teachers, situated professional development, teacher beliefs, teacher practices

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Authors: Kemka Ihemelandu, Chukwuemeka Ihemelandu

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Melanoma remains a public health crisis, with incidence rates increasing rapidly in the past decades. Improving diagnostic accuracy to decrease misdiagnosis using Artificial intelligence (AI) continues to be documented. Unfortunately, unintended racially biased outcomes, a product of lack of diversity in the dataset used, with a noted class imbalance favoring lighter vs. darker skin tone, have increasingly been recognized as a problem.Resulting in noted limitations of the accuracy of the Convolutional neural network (CNN)models. CNN models are prone to biased output due to biases in the dataset used to train them. Our aim in this study was the optimization of convolutional neural network algorithms to mitigate bias in the automated diagnosis of melanoma. We hypothesized that our proposed training algorithms based on a data augmentation method to optimize the diagnostic accuracy of a CNN classifier by generating new training samples from the original ones will reduce bias in the automated diagnosis of melanoma. We applied geometric transformation, including; rotations, translations, scale change, flipping, and shearing. Resulting in a CNN model that provided a modifiedinput data making for a model that could learn subtle racial features. Optimal selection of the momentum and batch hyperparameter increased our model accuracy. We show that our augmented model reduces bias while maintaining accuracy in the automated diagnosis of melanoma.

Keywords: bias, augmentation, melanoma, convolutional neural network

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Authors: Manpreet Kaur

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The effect of external and internal exposure in outdoor and indoor environment can be significantly gauged by natural radionuclides. Therefore, it is a consequential to approximate the level of radionuclide contents in soil samples of any area and the risks associated with it. Rate of radon emerging from soil is also one of the prominent parameters for the assessment of radon levels in environmental. In present study, natural radionuclide contents viz. ²³²Th, ²³⁸U and ⁴⁰K and radon/thoron exhalation rates were evaluated operating thallium doped sodium iodide gamma radiation detector and advanced Smart Rn Duo technique in the soil samples from 30 villages of Jammu district, Jammu and Kashmir, India. Radon flux rate was also measured by using surface chamber technique. Results obtained with two different methods were compared to investigate the cause of emanation factor in the soil profile. The radon mass exhalation rate in the soil samples has been found varying from 15 ± 0.4 to 38 ± 0.8 mBq kg⁻¹ h⁻¹ while thoron surface exhalation rate has been found varying from 90 ± 22 to 4880 ± 280 Bq m⁻² h⁻¹. The mean value of radium equivalent activity (99 ± 27 Bq kg⁻¹) was appeared to be well within the admissible limit of 370 Bq kg⁻¹ suggested by Organization for Economic Cooperation and Development (2009) report. The values of various parameters related to radiological hazards were also calculated and all parameters have been found to be well below the safe limits given by various organizations. The outcomes pointed out that region was protected from danger as per health risks effects associated with these radionuclide contents is concerned.

Keywords: absorbed dose rate, exhalation rate, human health, radionuclide

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Authors: Nasrin Badrkhani

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The increasing use of educational technologies has created a tremendous transformation in all fields and most importantly, in the field of education and learning. In recent decades, traditional learning approaches have undergone fundamental changes with the emergence of new learning technologies. Research shows that suitable educational tools play an effective role in the transmission, comprehension, and impact of educational concepts. These tools provide a tangible basis for thinking and constructing concepts, resulting in an increased interest in learning. They provide real and true experiences to students and convey educational meanings and concepts more quickly and clearly. It can be said that educational technology, as an active and modern teaching method, with capabilities such as engaging multiple senses in the educational process and involving the learner, makes the learning environment more flexible. It effectively impacts the skills of children with special needs by addressing their specific needs. Teachers are no longer the sole source of information, and students are not mere recipients of information. They are considered the main actors in the field of education and learning. Since education is one of the basic rights of every human being and children with special needs face unique challenges and obstacles in education, these challenges can negatively affect their abilities and learning. To combat these challenges, one of the ways is to use educational technologies for more diverse, effective learning. Also, the use of educational technology for students with special needs has increasingly proven effective in boosting their self-confidence and helping them overcome learning challenges, enhancing their learning outcomes.

Keywords: communication technology, students with special needs, self-confidence, raising the expectations and progress

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Authors: Alessandra Marino

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This paper thoroughly investigates the design characteristics necessary for intergenerational living and evaluates their applicability within the Italian social panorama in order to identify a model that can serve as a reference for subsequent regulatory adjustments of a new building typology. The applied methodology involves the collaboration of people with various background and architects, all representing the three main ages of life - childhood or youth, adulthood, seniority - through questionnaires aimed at researching the peculiar characteristics that contemporary intergenerational housing should include; the questionnaires are then compared with each other in order to identify any recurring patterns by age group and/or influenced by the specialist knowledge on the subject of the architects compared to the rest of the user sample. The results indicate that among specialist users in the field of architecture, young students identify home automation as the key to the inclusion of the weakest groups within the building, adult architects believe that the identification of intergenerational/community services within the building is the cornerstone, and senior architects focus on widespread spatial accessibility. At the same time, the results among non-specialist users do not identify a significantly diversified model by age group but are generally in agreement in the importance of separation between private environments and collective spaces. The interpretation of the results obtained leads to a compositional study of a new building typology with the future objective of channeling the subsequent outcomes within the regulatory adjustments of the sector.

Keywords: intergenerational living, social sustainability, health, lifestyle, well-being

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Authors: Caroline Hoorn

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Post-matriculants in disadvantaged communities such as Douglas encounter a number of career challenges. The transition to the democratic dispensation in 1994, coupled with the rapid changes in the information domain that are characteristic of post-industrial life, complicate the career development trajectories of disadvantaged youth. The career development stories and experiences of disadvantaged youth in provinces such as the Northern Cape have not been told, leading to their marginalisation. It is against this background that the study explored the gendered dimensions of career development narratives, experiences, and choices of post-matriculants in the Douglas community in the Northern Cape. Using a qualitative, narrative approach, the researcher elicited career development stories from 23 participants in Douglas using semi-structured interviews. Two main themes were highlighted through the narratives; (1) willingness to challenge the traditional male dominated career script (2) breaking gender barriers. The study showed that gender did not have any influence on the career choices of the post-matriculants. The perceptions around career choices and gender were being challenged partly by the urge to affirm equality and the constant reminder of the poverty-stricken conditions prevalent in the households. A preferred gender is not required to be attached to the fulfilment of outcomes in a knowledge-based economy. Thus, it is not an issue of gender or masculinity but knowledge and skills. Furthermore, the study revealed that the career choices being considered are still the traditionally stereotypical careers like nursing, teaching, and social work, which demonstrates a lack of information to a broader pool of career options to select from.

Keywords: career development, gender, narratives, post-matriculants

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Authors: Md Yeasin, Ranjit Kumar Paul

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In recent years, recommendation systems have become indispensable tools for agricultural system. The accurate and timely recommendations can significantly impact crop yield and overall productivity. Causal inference modeling aims to establish cause-and-effect relationships by identifying the impact of variables or factors on outcomes, enabling more accurate and reliable recommendations. New advancements in causal inference models have been found in the literature. With the advent of the modern era, deep learning and machine learning models have emerged as efficient tools for modeling. This study proposed an innovative approach to enhance recommendation systems-based machine learning based casual inference model. By considering the causal effect and opportunity cost of covariates, the proposed system can provide more reliable and actionable recommendations for cereal farmers. To validate the effectiveness of the proposed approach, experiments are conducted using cereal cultivation data of eastern India. Comparative evaluations are performed against existing correlation-based recommendation systems, demonstrating the superiority of the advanced causal inference modeling approach in terms of recommendation accuracy and impact on crop yield. Overall, it empowers farmers with personalized recommendations tailored to their specific circumstances, leading to optimized decision-making and increased crop productivity.

Keywords: agriculture, casual inference, machine learning, recommendation system

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Authors: Yaron Katz

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The investigation of immigrants' electoral choices has remained relatively uncharted territory despite the fact that numerous nations extend political rights to their expatriates. This paper centers its attention on the matter of public trust in democracy, with a focus on the intricacies of Israeli politics as a divided system. It delves into the potential implications of political and social transformations stemming from the involvement of expatriate voters in elections taking place in their country of origin. In doing so, the article endeavors to explore a pathway for resolving a persistent challenge facing the stability of the Israeli political landscape over the past decade: the difficulty in forming a resilient government that genuinely represents the majority of voters. An examination is conducted into the role played by a demographic with the capacity to exert significant influence on election outcomes, namely, individuals residing outside of Israel. The objective of this research is to delve into this subject, dissecting social developments and political prospects that may shape the country's trajectory in the coming decades. This inquiry is especially pertinent given the extensive engagement of migrants in Israeli politics and the link between Israelis living abroad and their home country. Nevertheless, the study's findings reveal that while former citizens exhibit extensive involvement in Israeli politics and are cognizant of the potential consequences of permitting them to participate in elections, they maintain steadfastly unfavorable views regarding the inclusion of Israelis living overseas in their home country's electoral processes.

Keywords: trust, globalization, policy, democracy

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Authors: Tasaduk Musood

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In the dynamic landscape of higher education, intra-regional migration within Kashmir represents a complex interplay of influential elements. This qualitative research study aims to explore and analyze the multifaceted factors that significantly shape the patterns and motivations driving students' migration within the region. The study employed a qualitative research approach. The research is carried out with a sample of 60 participants, consisting of 30 male and 30 female students selected from various higher education institutions in the Punjab region. Through self-structured interviews and thematic analysis, the research unravels the underlying drivers, aspirations, challenges, and opportunities that underpin the phenomenon of intra-regional migration in the Kashmiri higher education landscape. The results of this study are expected to offer valuable insights for policymakers, educational institutions, and stakeholders to better understand, address, and potentially enhance the experiences and outcomes of shareholders of students engaged in intra-regional mobility within Kashmir's higher education domain. This study's findings aim to contribute significantly to the existing body of knowledge surrounding intra-regional migration within Kashmir's higher education landscape, offering a nuanced understanding of the drivers behind student mobility. Ultimately, this research endeavors to facilitate more informed and effective decision-making in addressing the evolving dynamics of intra-regional migration in Kashmir's higher education sector.

Keywords: intra-regional migration, student migration patterns, student mobility, higher education, kashmir

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Authors: Rubina Ghani, Sehrish Zia, Afifa Fatima Rafique, Shaista Emad

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Background: Cancer is a leading cause of death worldwide, with breast cancer being the most common cancer in women. Pakistan has the highest rate of breast cancer cases among Asian countries. Early and accurate diagnosis is crucial for treatment outcomes and quality of life. Method: It is a case-control study with a sample size of 150. There were 100 suspected cancer cases, 25 healthy controls, and 25 diagnosed cancer cases. To analyze SSAT-1 mRNA expression in whole blood, Zymo Research Quick-RNA Miniprep and Innu SCRIPT—One Step RT-PCR Syber Green kits were used. Patients were divided into three groups: 100 suspected cancer cases, 25 controls, and 25 confirmed breast cancer cases. Result: The total mRNA was isolated, and the expression of SSAT-1 was measured using RT-qPCR. The threshold cycle (Ct) values were used to determine the amount of each mRNA. Ct values were then calculated by taking the difference between the CtSSAT-1 and Ct GAPDH, and further Ct values were calculated with the median absolute deviation for all the samples within the same experimental group. Samples that did not correlate with the results were taken as outliers and excluded from the analysis. The relative fold change is shown as 2^-Ct values. Suspected cases showed a maximum fold change of 32.24, with a control fold change of 1.31. Conclusion: The study reveals an overexpression of SSAT-1 in breast cancer. Furthermore, we can use SSAT-1 as a diagnostic, prognostic, and therapeutic marker for early diagnosis of cancer.

Keywords: breast cancer, spermidine/spermine, qPCR, mRNA

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Authors: Sun-Ki Choi

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The U.S. student loan policy was initiated to improve the equality of educational opportunity and help low-income families to provide higher education opportunities for their children. However, with the increase in the average student loan amount, college graduates with student loans experience problems and restrictions in their early-career choices. This study examines the early career labor market choices of college graduates who obtained student loans to finance their higher education. In this study, National Survey of College Graduates (NSCG) data for 2017 and 2019 was used to estimate the effects of student loans on the employment status and current job wages of graduates with student loans. In the analysis, two groups of workers, those with student loans and those without loans, were compared. Using basic models and Mahalanobis distance matching, it was found that graduates who rely on student loans to finance their education are more likely to participate in the labor market than those who do not. Moreover, in entry-level jobs, graduates with student loans receive lower salaries than those without student loans. College graduates make job-related decisions based on their current and future wages and fringe benefits. Graduates with student loans tend to demonstrate risk-averse behaviors due to their financial restrictions. Thus, student loan debt creates inequity in the early-career labor market for college graduates. Furthermore, this study has implications for policymakers and researchers in terms of the student loan policy.

Keywords: student loan, wage differential, unintended consequences, mahalanobis distance matching

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Authors: Adel Ali Elshaibani

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Risk management indicators augment the reporting infrastructure, particularly for the board and senior management, to identify, monitor, and manage risks. This enhancement facilitates improved decision-making throughout the banking organization. Decision tree analysis is a tool that visually outlines potential outcomes, costs, and consequences of complex decisions. It is particularly beneficial for analyzing quantitative data and making decisions based on numerical values. By calculating the expected value of each outcome, decision tree analysis can help assess the best course of action. In the context of banking, decision tree analysis can assist lenders in evaluating a customer’s creditworthiness, thereby preventing losses. However, applying these tools in developing countries may face several limitations, such as data availability, lack of technological infrastructure and resources, lack of skilled professionals, cultural factors, and cost. Moreover, decision trees can create overly complex models that do not generalize well to new data, known as overfitting. They can also be sensitive to small changes in the data, which can result in different tree structures and can become computationally expensive when dealing with large datasets. In conclusion, while risk management indicators and decision tree analysis are beneficial for decision-making in banks, their effectiveness is contingent upon how they are implemented and utilized by the board of directors, especially in the context of developing countries. It’s important to consider these limitations when planning to implement these tools in developing countries.

Keywords: risk management indicators, decision tree analysis, developing countries, board of directors, bank performance, risk management strategy, banking institutions

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Authors: Lolwa Alansari, Abdelhamid Azhaghdani, Sufia Athar, Hanen Mrabet, Annaliza Cruz, Tamara Alshadafat, Almunzer Zakaria

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Introduction: Improving the patient experience is a fundamental pillar of healthcare's quadruple aims. Recognizing the importance of patient experiences and perceptions in healthcare interactions is pivotal for driving quality improvement. This abstract centers around the Patient Experience Program, an endeavor crafted with the purpose of comprehending and elevating the experiences of patients in the Obstetrics & Gynecology Emergency Department (OB/GYN ED). Methodology: This comprehensive endeavor unfolded through a structured sequence of phases following Plan-Do-Study-Act (PDSA) model, spanning over 12 months, focused on enhancing patient experiences in the Obstetrics & Gynecology Emergency Department (OB/GYN ED). The study meticulously examined the journeys of patients with acute obstetrics and gynecological conditions, collecting data from over 100 participants monthly. The inclusive approach covered patients of different priority levels (1-5) admitted for acute conditions, with no exclusions. Historical data from March and April 2022 serves as a benchmark for comparison, strengthening causality claims by providing a baseline understanding of OB/GYN ED performance before interventions. Additionally, the methodology includes the incorporation of staff engagement surveys to comprehensively understand the experiences of healthcare professionals with the implemented improvements. Data extraction involved administering open-ended questions and comment sections to gather rich qualitative insights. The survey covered various aspects of the patient journey, including communication, emotional support, timely access to care, care coordination, and patient-centered decision-making. The project's data analysis utilized a mixed-methods approach, combining qualitative techniques to identify recurring themes and extract actionable insights and quantitative methods to assess patient satisfaction scores and relevant metrics over time, facilitating the measurement of intervention impact and longitudinal tracking of changes. From the themes we discovered in both the online and in-person patient experience surveys, several key findings emerged that guided us in initiating improvements, including effective communication and information sharing, providing emotional support and empathy, ensuring timely access to care, fostering care coordination and continuity, and promoting patient-centered decision-making. Results: The project yielded substantial positive outcomes, significantly improving patient experiences in the OB/GYN ED. Patient satisfaction levels rose from 62% to a consistent 98%, with notable improvements in satisfaction with care plan information and physician care. Waiting time satisfaction increased from 68% to a steady 97%. The project positively impacted nurses' and midwives' job satisfaction, increasing from 64% to an impressive 94%. Operational metrics displayed positive trends, including a decrease in the "left without being seen" rate from 3% to 1%, the discharge against medical advice rate dropping from 8% to 1%, and the absconded rate reducing from 3% to 0%. These outcomes underscore the project's effectiveness in enhancing both patient and staff experiences in the healthcare setting. Conclusion: The use of a patient experience questionnaire has been substantiated by evidence-based research as an effective tool for improving the patient experience, guiding interventions, and enhancing overall healthcare quality in the OB/GYN ED. The project's interventions have resulted in a more efficient allocation of resources, reduced hospital stays, and minimized unnecessary resource utilization. This, in turn, contributes to cost savings for the healthcare facility.

Keywords: patient experience, patient survey, person centered care, quality initiatives

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Authors: Mohadeseh Shojaei Shahrokhabadi, Ding-Geng (Din) Chen

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Positive continuous outcomes with a substantial number of zero values and incomplete longitudinal follow-up are quite common in medical cost data. To jointly model semi-continuous longitudinal cost data and survival data and to provide marginalized covariate effect estimates, a marginalized two-part joint model (MTJM) has been developed for outcome variables with lognormal distributions. In this paper, we propose MTJM models for outcome variables from a generalized gamma (GG) family of distributions. The GG distribution constitutes a general family that includes approximately all of the most frequently used distributions like the Gamma, Exponential, Weibull, and Log Normal. In the proposed MTJM-GG model, the conditional mean from a conventional two-part model with a three-parameter GG distribution is parameterized to provide the marginal interpretation for regression coefficients. In addition, MTJM-gamma and MTJM-Weibull are developed as special cases of MTJM-GG. To illustrate the applicability of the MTJM-GG, we applied the model to a set of real electronic health record data recently collected in Iran, and we provided SAS code for application. The simulation results showed that when the outcome distribution is unknown or misspecified, which is usually the case in real data sets, the MTJM-GG consistently outperforms other models. The GG family of distribution facilitates estimating a model with improved fit over the MTJM-gamma, standard Weibull, or Log-Normal distributions.

Keywords: marginalized two-part model, zero-inflated, right-skewed, semi-continuous, generalized gamma

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Authors: Mitchell T. Grothaus, Cory Grigsby, Timothy S. Hare

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This study aims to determine if there is a relationship between elevated cancer risks in eastern Kentucky and the environmental effects of black shale. Previous research shows that black shale formations, such as those in eastern Kentucky contain high levels of toxic elements including arsenic and radon compared to average rocks and sediment. Similarly, the population of eastern Kentucky has higher rates of many health conditions, including lung cancer and cardiovascular disease, than surrounding regions. These poor health outcomes are typically explained in relation to social, economic, behavioral, and healthcare factors. The rates of many conditions, however, have not decreased as these factors improve with regional development. Black shale is known to affect environmental conditions such as by increasing radiation levels and heavy metal toxicity. We are mapping the effects of black shale through monitoring radiation, microbes, and chemical standards of water sources. In this presentation, we report on our measuring pH, dissolved oxygen, total dissolved solids, conductivity, temperature, and discharge and comparison with water quality standards from the Kentucky Department for Environmental Protection. The conditions of water sources combined with an environmental survey of the surrounding areas provide a greater understanding of why the people in eastern Kentucky face the current health issues.

Keywords: black shale, eastern Kentucky, environmental impact, water quality

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Authors: Salma Krafessi

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The financial markets have a multifaceted, intricate environment, and enormous volumes of data are produced every day. To find investment possibilities, possible fraudulent activity, and market oddities, accurate anomaly identification in this data is essential. Conventional methods for detecting anomalies frequently fail to capture the complex organization of financial data. In order to improve the identification of abnormalities in financial time series data, this study presents Tucker Decomposition as a reliable multi-way analysis approach. We start by gathering closing prices for the S&P 500 index across a number of decades. The information is converted to a three-dimensional tensor format, which contains internal characteristics and temporal sequences in a sliding window structure. The tensor is then broken down using Tucker Decomposition into a core tensor and matching factor matrices, allowing latent patterns and relationships in the data to be captured. A possible sign of abnormalities is the reconstruction error from Tucker's Decomposition. We are able to identify large deviations that indicate unusual behavior by setting a statistical threshold. A thorough examination that contrasts the Tucker-based method with traditional anomaly detection approaches validates our methodology. The outcomes demonstrate the superiority of Tucker's Decomposition in identifying intricate and subtle abnormalities that are otherwise missed. This work opens the door for more research into multi-way data analysis approaches across a range of disciplines and emphasizes the value of tensor-based methods in financial analysis.

Keywords: tucker decomposition, financial markets, financial engineering, artificial intelligence, decomposition models

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Authors: Alhassan Dramani Yakubu

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The primary purpose of this study was to analyze effects that participating in sporting activities has on academic performance among students at Yaa Asantewaa Girls’ Senior High School. To dig out the main objective of the study, descriptive survey design was employed. The study used 45 respondents comprising of 25 student – athletes and 20 non-student – athletes. The purposive sampling and stratified random sampling technique were used to sample population of 455 students involved. The academic performance of sports participants is compared with those of non – participants in terms of their outcomes in the form of grades from mathematics. Data was obtained from the sample by the use of questionnaire which was self - administered. The questionnaire sought information on level of student’s participation in sports and importance of sports participation to students. Results revealed that participation in sporting activities is associated with higher grades among students. The analysis reinforces the idea that apart from their health benefits for participants, sporting activities lead to the attainment of the performance goals to which higher institutions aspire. The findings also implies that, mathematics teachers and other subject teachers should not fend off students from participating in sporting activities with the trepidation that participating in sports inflame academic performance. This study recommend that, educational programs about sports should be provided for students’ through the educational system to bring about positive academic performance.

Keywords: physical activity, physical education, intra mural, extra mural

Procedia PDF Downloads 62