Search results for: best evidence

Authors: Naveed Chughtai, Salman Atif, Azhar Ali Taj, Murtaza Asghar Bukhari

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Accessible transport systems play a crucial role in infrastructure management and ease of access to destinations. Thus, the necessity of knowledge of service coverage and service deprived areas is a prerequisite for devising policies. Integration of PTALs model with GIS network analysis models (Service Area Analysis, Closest Facility Analysis) facilitates the analysis of deprived areas. In this research, models presented determine the accessibility. The empirical evidence suggests that current bus network system caters only 18.5% of whole population. Using network analysis results as inputs for PTALs, it is seen that excellent accessibility indexed bands cover a limited areas, while 78.8% of area is totally deprived of any service. To cater the unserved catchment, new route alignments are proposed while keeping in focus the Socio-economic characteristics, land-use type and net population density of the deprived area. Change in accessibility with proposed routes show a 10% increment in service delivery and enhancement in terms of served population is up to 20.4%. PTALs result shows a decrement of 60 Km2 in unserved band. The result of this study can be used for planning, transport infrastructure management, allocation of new route alignments in combination with future land-use development and for adequate spatial distribution of service access points.

Keywords: GIS, public transport accessibility, PTALs, accessibility index, service area analysis, closest facility analysis

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Authors: Seyedmirsajad Mokhtarimousavi, Danial Talebi, Hamidreza Asgari

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Assigning aircrafts’ activities to appropriate gates is one the most challenging issues in airport authorities’ multiple criteria decision making. The potential financial loss due to imbalances of demand and supply in congested airports, higher occupation rates of gates, and the existing restrictions to expand facilities provide further evidence for the need for an optimal supply allocation. Passengers walking distance, towing movements, extra fuel consumption (as a result of awaiting longer to taxi when taxi conflicts happen at the apron area), etc. are the major traditional components involved in GAP models. In particular, the total cost associated with gate assignment problem highly depends on the airport terminal layout. The study herein presents a well-elaborated literature review on the topic focusing on major concerns, applicable variables and objectives, as well as proposing a three-objective mathematical model for the gate assignment problem. The model has been tested under different concourse layouts in order to check its performance in different scenarios. Results revealed that terminal layout pattern is a significant parameter in airport and that the proposed model is capable of dealing with key constraints and objectives, which supports its practical usability for future decision making tools. Potential solution techniques were also suggested in this study for future works.

Keywords: airport management, terminal layout, gate assignment problem, mathematical modeling

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Authors: María Araya Léon, Ainoa Abella, Aura Murillo, Ricardo Guasch, Laura Clèries

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Objectives: This article aims to examine scientific theory framed within the term hospitals of the future from a multidisciplinary and cross-sectional perspective. To understand the connection that the various cross-sectional areas we studied have with architectural spaces and to determine the future outlook of the works examined and how they can be classified into the categories of need/solution, evolution/revolution, collective/individual, and preventive/corrective. Background: The changes currently taking place within the context of healthcare demonstrate how important these projects are and the need for companies to face future changes. Method: A systematic review has been carried out focused on what will the hospitals of the future be like in relation to the elements that form part of their use, design, and architectural space experience, using the WOS database from 2016 to 2019. Results: The large number of works about sensoring & big data and the scarce amount related to the area of materials is worth highlighting. Furthermore, no growth concerning future issues is envisaged over time. Regarding classifications, the articles we reviewed address evolutionary and collective solutions more, and in terms of preventive and corrective solutions, they were found at a similar level. Conclusions: Although our research focused on the future of hospitals, there is little evidence representing this approach. We also detected that, given the relevance of the research on how the built environment influences human health and well-being, these studies should be promoted within the context of healthcare.

Keywords: hospitals, future, architectural space, disruptive approach

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Authors: Saeed Pourhassan, Nastaran Maghbouli

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1) Background It has been hypothesized that, in individuals with diabetes mellitus, the peripheral nerve is swollen due to sorbitol over-accumulation. Additionally growing evidence supported electro diagnostic study of diabetes induced neuropathy as a method having some challenges. 2) Objective To examine the performance of sonographic cross-sectional area (CSA) measurements in the diagnosis of diabetic polyneuropathy (DPN). 3) Data Sources Electronic databases, comprising PubMed and EMBASE and Google scholar, were searched for the appropriate studies before Jan 1, 2020. 4) Study Selection Eleven trials comparing different peripheral nerve CSA measurements between participants with and without DPN were included. 5) Data Extraction Study design, participants' demographic characteristics, diagnostic reference of DPN, and evaluated peripheral nerves and methods of CSA measurement. 6) Data Synthesis Among different peripheral nerves, Tibial nerve diagnostic odds ratios pooled from five studies (713 participants) were 4.46 (95% CI, 0.35–8.57) and the largest one with P<0.0001, I²:64%. Median nerve CSA at wrist and mid-arm took second and third place with ORs= 2.82 (1.50-4.15), 2.02(0.26-3.77) respectively. The sensitivities and specificities pooled from two studies for Sural nerve were 0.78 (95% CI, 0.68–0.89), and 0.68 (95% CI, 0.53–0.74). Included studies for other nerves were limited to one study. The largest sensitivity was for Sural nerve and the largest specificity was for Tibial nerve. 7) Conclusions The peripheral nerves CSA measured by ultrasound imaging is useful for the diagnosis of DPN and is most significantly different between patients and participants without DPN at the Tibial nerve. Because the Tibial nerve CSA in healthy participants, at various locations, rarely exceeds 24 mm2, this value can be considered as a cutoff point for diagnosing DPN.

Keywords: diabetes, diagnosis, polyneuropathy, ultrasound

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Authors: Muhamad Saiful Bahri Yusoff

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This study aimed to evaluate the construct, convergent, and discriminant validity of the Secondary School Stressor Questionnaire (3SQ) as well as to evaluate its internal consistency among adolescents in Malaysian secondary schools. A cross-sectional study was conducted on 700 secondary school students in five secondary schools. Stratified random sampling was used to select schools and participants. The confirmatory factor analysis was performed by AMOS to examine construct, convergent, and discriminant validity. The reliability analysis was performed by SPSS to determine internal consistency. The results showed that the original six-factor model with 44 items failed to achieve acceptable values of the goodness of fit indices, suggesting poor model fit. The new five-factor model of 3SQ with 22 items demonstrated acceptable level of goodness of fit indices to signify a model fit. The overall Cronbach’s alpha value for the new version 3SQ was 0.93, while the five constructs ranged from 0.68 to 0.94. The composite reliability values of each construct ranged between 0.68 and 0.93, indicating satisfactory to high level of convergent validity. Our study did not support the construct validity of the original version of 3SQ. We found the new version 3SQ showed more convincing evidence of validity and reliability to measure stressors of adolescents. Continued research is needed to verify and maximize the psychometric credentials of 3SQ across countries.

Keywords: stressors, adolescents, secondary school students, 3SQ, psychometric properties

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Authors: Irina S. Burashnikova, Dmitriy A. Sychev, Ruslan Y. Kazakov

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Сytochrome P450 CYP2D6 activity affects antipsychotic therapy safety. CYP2D6*4 polymorphism frequency varies among different ethnic groups. We studied CYP2D6*4 polymorphism frequency in Tatar and Russian schizophrenic patients and association of CYP2D6*4 polymorphism and extrapyramidal disorders (EPD) frequency in schizophrenic patients on haloperidol monotherapy in daily doses up to 20 mg. Results: Heterozygous CYP2D6*4 allele carrier frequency among Tatars was lower (23.8% vs 32.4% in Russians), but the differences did not reach statistical significance. CYP2D6*4 allele frequency among Tatars was also lower (11.9% vs 24.3% in Russians), but the difference was not quite significant (p=0.0592). Average daily haloperidol dose in the group without EPD was significantly higher than in the group with EPD (11.35±4.6 vs 13.87±3.3 mg, p=0.0252), but average daily haloperidol dose/weight ratios in the compared groups had no significant differences. Statistically significant association between EPD development and heterozygous CYP2D6*1/*4 genotype and CYP2D6*4 allele carrier frequency was revealed among all schizophrenic patients and among those of Tatar nationality. Further well designed pharmacogenetic studies in different Russian regions are needed to improve psychotropic therapy safety and to establish evidence-based indications for pharmacogenetic testing in clinical practice.

Keywords: antipsychotic, CYP2D6 polymorphism, ethnic differences of CYP2D6*4 allele frequency, extrapyramidal side effects/disorder, schizophrenia, pharmacogenetics, Russians, Tatars

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Authors: Nassier A. Nassir, Robert Birch, D. Rico Sierra, S. P. Edwardson, G. Dearden, Zhongwei Guan

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The effect of laser surface treatment parameters on the residual strength of titanium alloy has been investigated. The influence of the laser surface treatment on the bonding strength between the titanium and poly-ether-ketone-ketone (PEKK) surfaces was also evaluated and compared to those offered by titanium foils without surface treatment to optimize the laser parameters. Material characterization using an optical microscope was carried out to study the microstructure and to measure the mean roughness value of the titanium surface. The results showed that the surface roughness shows a significant dependency on the laser power parameters in which surface roughness increases with the laser power increment. Moreover, the results of the tensile tests have shown that there is no significant dropping in tensile strength for the treated samples comparing to the virgin ones. In order to optimize the laser parameter as well as the corresponding surface roughness, single-lap shear tests were conducted on pairs of the laser treated titanium stripes. The results showed that the bonding shear strength between titanium alloy and PEKK film increased with the surface roughness increment to a specific limit. After this point, it is interesting to note that there was no significant effect for the laser parameter on the bonding strength. This evidence suggests that it is not necessary to use very high power of laser to treat titanium surface to achieve a good bonding strength between titanium alloy and the PEKK film.

Keywords: bonding strength, laser surface treatment, PEKK, poly-ether-ketone-ketone, titanium alloy

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Authors: Sajed Yaghoubnezhad, Sedygheh Rezai

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Background and Aim: Since currently in Iran, students with learning disabilities are identified after entering school, and with the approach to the gap between IQ and academic achievement, the purpose of this study is to design and calculate the content validity of the pre-school screening checklist (5-7) exposed to learning difficulties. Methods: This research is a fundamental study, and in terms of data collection method, it is quantitative research with a descriptive approach. In order to design this checklist, after reviewing the research background and theoretical foundations, cognitive abilities (visual processing, auditory processing, phonological awareness, executive functions, spatial visual working memory and fine motor skills) are considered the basic variables of school learning. The basic items and worksheets of the screening checklist of pre-school students 5 to 7 years old with learning difficulties were compiled based on the mentioned abilities and were provided to the specialists in order to calculate the content validity ratio index. Results: Based on the results of the table, the validity of the CVR index of the background information checklist is equal to 0.9, and the CVR index of the performance checklist of preschool children (5 to7 years) is equal to 0.78. In general, the CVR index of this checklist is reported to be 0.84. The results of this study provide good evidence for the validity of the pre-school sieve screening checklist (5-7) exposed to learning difficulties.

Keywords: checklist, screening, preschoolers, learning difficulties

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Authors: Md. Rashed Aalm, Md. Nuruzzaman Khan, Yothin Sawangdee

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Background: Around 47% of the total pregnancies are unintended in Bangladesh, which lead to several adverse consequences, including maternal and child mortality. Use of menstrual regulation (MR) can help women to reduce unintended pregnancy related adverse consequences. We explored the prevalence and determinants of MR services among ever-married women in Bangladesh. Methods: Total of 14,346 ever-married women data were analysed from the 2017 Bangladesh Demographic and Health Survey. Our study variable was use or non-use of MR services. Individual, household, and community level factors were the explanatory factors. Multilevel mixed-effect Poisson regression model was used to determine the factors associated with MR services in Bangladesh. Results: Nearly 7% of the total women in Bangladesh use MR services. Use of MR services was found higher among women who were aged 20-30 ages (IRR 1.60, 95% CI: 1.17–2.17), who were overweight (IRR 1.43, 95% CI: 1.13–1.81), had at least 1 child (IRR 2.97, 95% CI: 2.34– 3.77) or > 2 children (IRR 3.22, 95% CI: 2.45–4.20), and the birth preceding birth interval was(2 – 4) years (IRR 1.56, 95% CI: 1.13–2.15). Around 1.39 times (95% CI: 1.11–1.73) higher likelihood of MR was found among women whose husbands were engage with business. At the community level, MR service was found lower among the women who resided in the community with higherilliteracy (IRR 0.67, 95% CI: 0.42–0.96) and the Mymensingh division (IRR 0.39, 95% CI: 0.31–0.91). Conclusion: Use of MR service is comparatively low, which indicate a significant proportion of unintended pregnancy continued toward life-birth. This could be responsible for higher adverse maternal and child health outcomes in Bangladesh. Initiatives should be taken to ensure MR services is available when women need this service.

Keywords: menstrual regulation, pattern, risk, maternal health, Bangladesh

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Authors: Habson Batubara, Patawari, Lisa Mery, Mohammad Syaichuddin, Sitti Faridah, Hamzah, Akmal, Abdul Gafur, Iman Sudrajad, Lideman, Yuani Mundaya, Kamaruddin, Muslimin, Herlina Jompa, Joula Sondack, Nani Undap, Suciati, Elisa Winanda, Arfandi Amin, Suciati

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This study aims to determine the status of the law, legislation, and its implementation against Foreign Nationals (WNA) Illegal Fishing Business Actors in the waters of the Indonesian Exclusive Economic Zone (EEZ), based on the Indonesian Positive Law and UNCLOS 1982. The research method used is normative juridical with a qualitative approach to study the Fisheries Criminal Verdict (Tipikan) and the Bitung District Court / Fisheries SIPP from 2019 to 2020. The results showed that cases of Illegal Fishing by Foreign Nationals (WNA) in the Indonesian Exclusive Economic Zone (EEZ) were examined, tried, and decided in accordance with the fisheries law, criminal sanctions were not in accordance with and contrary to Indonesian positive law, both criminal law and fisheries law, but followed and were in line with UNCLOS Year 1982. Legal status and responsibility are only imposed on the master as the leader on board the ship as the representative of the ship owner/company. Meanwhile, the application of Indonesia's positive law to Unclos in 1982 was only in the form of fines and confiscation of evidence as an effort to seek compensation for illegal fishing activities in the waters of the Indonesian Exclusive Zone (EEZ).

Keywords: EEZ, illegal fishing, WNA, positive law, Unclos 1982

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Authors: Mohamed Fadzlee Sulaiman, Zainurrasyid Abdullah, Mohd Zabri Adil Talib, Aswami Fadillah Mohd Ariffin

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In common digital forensics cases, investigation may rely on the analysis conducted on specific and relevant exhibits involved. Usually the investigation officer may define and advise digital forensic analyst about the goals and objectives to be achieved in reconstructing the trail of evidence while maintaining the specific scope of investigation. With the technology growth, people are starting to realize the importance of cyber security to their organization and this new perspective creates awareness that digital forensics auditing must come in place in order to measure possible threat or attack to their cyber-infrastructure. Instead of performing investigation on incident basis, auditing may broaden the scope of investigation to the level of anomaly detection in daily operation of organization’s cyber space. While handling a huge amount of data such as log files, performing digital forensics audit for large organization proven to be onerous task for the analyst either to analyze the huge files or to translate the findings in a way where the stakeholder can clearly understand. Data visualization can be emphasized in conducting digital forensic audit and investigation to resolve both needs. This study will identify the important factors that should be considered to perform data visualization techniques in order to detect anomaly that meet the digital forensic audit and investigation objectives.

Keywords: digital forensic, data visualization, anomaly detection , log analysis, forensic audit, visualization techniques

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Authors: Mariana Mangas, Yaroslava Martins, Ana Charraz, Ana Matos Pires

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Introduction: Health literacy empowers people of knowledge, motivation and skills to access, understand, evaluate and mobilize information relating to health. Although the benefits of public knowledge of physical disease are widely accepted, knowledge about mental disorder has been compatibly neglected. Nowadays there is considerably evidence that literacy is of great importance for the promotion of health and prevention of mental illness. Objective: Disclosure the concept and importance of mental health literacy and introduce the literacy program of Psychiatry Service of Hospital José Joaquim Fernandes. Methodology: A search was conducted on PubMed, using keywords “literacy” and “mental health”. A description of mental health literacy interventions implemented on Psychiatry Service of Hospital José Joaquim Fernandes was performed, namely, psychoeducation programs for depression and bipolar disorder. Results and discussion: Health literacy enables patient to be able to actively participate in his treatment. The improving of mental health literacy can promote early identification of mental disorders, improve treatment results, increase the use of health services and allow the community to take action to achieve better mental health. Psychoeducation is very useful in improving the course of disease and in reducing the number of episodes and hospitalizations. Bipolar patients who received psychoeducation and pharmacotherapy have no relapses during the program and last year. Conclusion: Mental health literacy is not simply a matter of having knowledge, rather, it is knowledge linked to action which can benefit mental health.

Keywords: mental health, literacy, psychoeducation, knowledge, empowerment

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Authors: Jennifer Bradley

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With opportunities to live and work abroad on the rise, effective preparation and support for international employees needs to be addressed within the work-site. International employees must build new habits, routines and social networks in an unfamiliar culture. Culture shock typically occurs within the first year and can affect both physical and psychological health. Employers have the opportunity to support staff through the adaptation process and foster healthy habits and routines. Cross-cultural training that includes a combination of instructional teaching, cultural experiences, and practice, is shown to increase the international employee adaptation process. However, little evidence demonstrates that organizations provide all of these aspects for international employees. The occupational therapy practitioner (OTP) offers a unique perspective focusing on the employee transactional relationship and engagement of meaningful occupations to enhance and enable participation in roles, habits and routines within new cultural contexts. This paper examines one such program developed and implemented by an OTP at the New England Center for Children, in Abu Dhabi, United Arab Emirates. The effectiveness of the program was assessed via participant feedback and concluded that an international employee support program that focuses on a variety of meaningful experiences and knowledge can empower employees to navigate healthy practices, develop habits and routines, and foster positive inter-cultural relationships in the organization and community.

Keywords: occupational therapy practitioner, cross cultural training, international employee health, international employee support

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Authors: Vatasta Koul, Ayush Gupta, Vaibhav Sharma, Rajesh Yadav

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Today we are unmarking the secrets of the universe by exploring different stars and planets and most of the space exploration is done by unmanned space robots. In addition to our planet Earth, there are pieces of evidence that show other astronomical objects in our solar system such as Venus, Mars, Saturn’s moon Titan and Uranus support the flight of fixed wing air vehicles. In this paper, we take forward the concept of presence of large rounded tubercles along the leading edge of a wing and use it as a passive flow control device that will help in improving its aerodynamic performance and maneuverability. Furthermore, in this research, aerodynamic measurements and performance analysis of wavy leading tubercles on the fixed wings at 5-degree angle of attack are carried out after determination of the flow conditions on the selected planetary bodies. Wavelength and amplitude for the sinusoidal modifications on the leading edge are analyzed and simulations are carried out for three-dimensional NACA 0012 airfoil maintaining unity AR (Aspect Ratio). Tubercles have consistently demonstrated the ability to delay and decrease the severity of stall as per the studies were done in the Earth’s atmosphere. Implementing the same design on the leading edges of Micro-Air Vehicles (MAVs) and UAVs could make these aircrafts more stable over a greater range of angles of attack in different planetary environments of our solar system.

Keywords: amplitude, NACA0012, tubercles, unmanned space robots

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Authors: Nkereke Mfon Essien

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In an ambisyllabic environment, one consonant sound simultaneously assumes both the coda and onset positions of a word due to its structural proclivity to affect two phonological processes or repair two ill-formed sequences in those syllable positions at the same time. This study sets out to examine the structural conditions that trigger this not-so-common phonological privilege for consonant sounds in the English language and Nigerian English and if such constraints could have any correspondence in the language studied. Data for the study were obtained from a native speaker of English who was the control and twenty (20) educated Nigerian speakers of English from the three ethnic/linguistic groups in Nigeria. Preliminary findings from the data show that ambisyllabicity in English is triggered mainly by stress, a condition which causes a consonant in a stressed syllable to become glottalised and simultaneously devoices the nearest voiced consonant in the next syllable. For example, in the word coupler,/'kʌplɜr/ is realized as ['kʌˀpl̥ɜr]. In some Nigerian English, preliminary findings show that ambisyllabicity is triggered by a sequence of intervocalic short, high central vowels and a coda nasal. Since the short vowel may not occur in an open syllable, the nasal serves to close the impermissible open syllable. However, since the Nigerian English foot structure does not permit a CVC.V syllable, the same coda nasal simultaneously repairs the impermissible syllable foot to (CV.CV) by applying the Maximal Onset Principle since this is a preliminary investigation, a conclusion would not suffice yet.

Keywords: ambisyllabicity, nasal, coda, stress, phonological process, syllable, foot

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Authors: Jeffey George, Varghese Thomas

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Background and Objectives: PHG is an important source of gastrointestinal bleeding in patients with portal hypertension. Aim: To assess the progression to severe portal hypertensive gastropathy(PHG) in patients with cirrhosis who were treated with maximum tolerated dose of propranalol, after variceal eradication to grade II or below. Methods: Cirrhotic patients(child A and B) presenting with upper gastrointestinal bleeding with endoscopic findings of mild or no PHG were followed up over 6 months after variceal eradication to assess the progression to severe PHG. Included patients were randomised to either maximum tolerated doses of propranalol (group A) or to no treatment (group B). Primary end point of the study were the development of gastrointestinal bleed, evidence of hepatic decompensation and death. Progression to severe PHG were compared between the two groups. Results: 56 patients (49 males) were enrolled (group A = 28, group B = 28). 8 patients were excluded from final analysis (gi bleed=5, encephalopathy=2,HCC=1 including 4 deaths).3 patients were lost to follow-up, and 1 developed intolerance to propranalol. Mean dose of propranalol used was 60 mg per day. Progression to severe PHG in the fundus over 6 months was 23.8% in group A versus 15.8 % in group B (p = 0.52). Severe PHG was noted in body in 14.3% in group A versus 21.1% in group B (p = 0.57). 23.8 % in group A had progression to severe PHG compared with 15.8 % in group B (p =0.52). There was no statistically significant difference in the progression of PHG between the two groups(p=0.43). Conclusion: In this short term study propranalol was found not to prevent the progression to severe portal hypertensive gastropathy in cirrhotic patients who had undergone endotherapy for esophageal varices.

Keywords: propranalol, portal hypertensive gastropathy, cirrhotic patients, gastroenterology

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Authors: Pooja Booluck

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A U-shaped learning curve entails a three-step process: a good performance followed by a bad performance followed by a good performance again. U-shaped curves have been observed not only in language acquisition but also in various fields such as temperature face recognition object permanence to name a few. Building on previous studies of the curve child language acquisition and Second Language Acquisition this empirical study seeks to investigate the relevance of the U-shaped learning model to the acquisition of the difference between cest and il est in the English Learners of French context. The present study was developed to assess whether older learners of French in the ELF context follow the same acquisition pattern. The empirical study was conducted on 15 English learners of French which lasted six weeks. Compositions and questionnaires were collected from each subject at three time intervals (after one week after three weeks after six weeks) after which students work were graded as being either correct or incorrect. The data indicates that there is evidence of a U-shaped learning curve in the acquisition of cest and il est and students did follow the same acquisition pattern as children in regards to rote-learned terms and subject clitics. This paper also discusses the need to introduce modules on U-shaped learning curve in teaching curriculum as many teachers are unaware of the trajectory learners undertake while acquiring core components in grammar. In addition this study also addresses the need to conduct more research on the acquisition of rote-learned terms and subject clitics in SLA.

Keywords: child language acquisition, rote-learning, subject clitics, u-shaped learning model

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Authors: Fahmi Hassan, Noorizan Abdul Aziz, Yahaya Hassan, Hazlinda Abu Hassan

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Sepsis incidence in critical care settings is a major problem in health care. Extended antibiotic infusion is thought to be superior to traditional dosing especially when treating critically ill patients with sepsis. We compared clinical outcomes of critically ill patients with sepsis receiving 30-minute meropenem infusion and three-hour meropenem infusion. A retrospective case-control study was conducted among septic patients treated with meropenem infusion in ICUs of three hospitals. Patients included in the study received either extended or standard meropenem infusion as per the practice of individual settings. Outcomes and clinical data were retrospectively collected from the electronic databases and patients’ files. A total of 108 patients received extended meropenem infusion while another 117 patients received standard meropenem infusion. Patients receiving the extended meropenem infusion were found to have a significantly lower shorter length of hospital and ICU stay. It was also found that among those receiving extended meropenem infusion, 54.7% (64/117) had a reduction of SAPS II score, while only 44% (48/108) of patients receiving standard meropenem infusion had reduced scores. This study will strengthen the evidence in using extended meropenem infusion as a standard practice in critical care settings. As this is the first study of its kind done in Malaysia, it proves that prolonged meropenem infusion may be beneficial to critically ill patients with sepsis. However, randomized clinical trials with large sample size should be carried out in local settings in order to minimize other confounders that may influence with the result of the study.

Keywords: antibiotics, beta lactams, critical care, extended infusion, meropenem

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Authors: Arielle Ferdinand

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A plant-based diet focuses on foods from plant sources, limiting or altogether omitting animal products. Some of the most common chronic illnesses seen in primary care are hypertension, hyperlipidemia, and diabetes type II. These common chronic illnesses can often be debilitating, costly, time-consuming, and, when left untreated, can lead to an early death. Treatment and maintenance of care are also labor intensive for the patient. They are often required to have at least four blood pressure checks yearly and a hemoglobin A1C checked quarterly. Though preventative interventions and prevention education should be included in patient visits in the primary care setting, education about dietary interventions, such as a plant-based diet, also yields positive outcomes for patients who already have hypertension, hyperlipidemia, and diabetes mellitus type 2. Evidence will show that incorporating a plant-based diet results in decreased blood pressure, as well as decreased levels of LDL-C, improved post-prandial glucose levels, and a reduction in HbA1C. It is cost-effective for the patient by generally lower grocery costs, and it can either reduce or prevent the need to pay for more office visits and pharmacotherapy. Incorporating this method of dietary changes is an easy intervention during a primary care office visit that would greatly benefit the patient in many ways.

Keywords: plant-based, nutrition, diabetes, hyperlipidemia

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Authors: Wan You Ning

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Addressing the rising prevalence of mental health issues among youths, the Multi-dimensional Approach to Resilience and Support in Advanced School-based Mental Health Service Delivery (MARS-ASMHSD) framework proposes the implementation of advanced mental health services in low-resource areas to further instil mental health resilience among students in a school-based setting. Recognizing the unsustainability of direct service delivery due to rapidly growing demands and costs, the MARS-ASMHSD framework endorses the deinstitutionalization of mental healthcare and explores a tiered, multi-dimensional approach in mental healthcare provision, establishing advanced school-based mental health service delivery. The framework is developed based on sustainable and credible evidence-based practices and modifications of existing mental health service deliveries in Asia, including Singapore, Thailand, Malaysia, Japan, and Taiwan. Dissemination of the framework model for implementation will enable a more progressive and advanced school-based mental health service delivery in low-resource areas. Through the evaluation of the mental health landscape and the role of stakeholders in the respective countries, the paper concludes with a multi-dimensional framework model for implementation in low-resource areas. A mixed-method independent research study is conducted to facilitate the framework's development.

Keywords: mental health, youths, school-based services, framework development

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Authors: Daphine Namara, Jeremy I. Schwartz, Andrew K. Tusubira, Willi McFarland, Caroline Birungi, Fred C. Semitala, Martin Muddu

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Emerging evidence suggests a possible association between hyperglycemia and dolutegravir (DTG), a preferred first-line antiretroviral agent in sub-Saharan Africa (SSA). There is a need for rigorous studies to validate this association in the face of increasing DTG use and the burden of non-communicable diseases among people living with HIV (PLHIV). We conducted a case-control study to assess the risk of hyperglycemia associated with the use of DTG among PLHIV attending Mulago ISS Clinic in Kampala. Cases had hyperglycemia, while controls had no hyperglycemia, as confirmed by fasting plasma glucose and oral glucose tolerance tests. Demographic, laboratory, and clinical data were collected using interviewer-administered questionnaires and medical record abstraction. The analysis compared cases and controls on DTG use prior to diagnosis of hyperglycemia while controlling for potential confounders using multivariable logistic regression. We included 204 cases and 231 controls. In multivariable analysis, patients with prior DTG use had seven times greater odds of subsequent diagnosis of hyperglycemia compared to those who had non-DTG-based regimens (adjusted odds ratio [aOR] 7.01, 95% CI 1.96-25.09). The odds of hyperglycemia also increased with age (56 years and above vs. 18-35, aOR 12.38, 95% CI 3.79-40.50) and hypertension (aOR 5.78, 95% CI 2.53-13.21). Our study demonstrates a strong association between prior DTG exposure and subsequent diagnosis of hyperglycemia. Given the benefits of DTG, wide-scale use, and the growing burden of diabetes mellitus (DM) in SSA, there is a need for systematic screening for hyperglycemia and consideration of alternate regimens for those at risk for DM.

Keywords: HIV, hyperglycemia, doluteravir, diabetes

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Authors: Nada Alqadri, Omaima Nasir

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Natural compounds are an important source of potential inhibitors; they have a lot of pharma potential with less adverse effects. The effective antiviral activities of natural products have been proved in different studies. The outbreak of COVID-19 in Wuhan, Hubei, in December 2019, coronavirus has had a significant impact on people's health and lives. Based on previous studies, natural products can be introduced as preventive and therapeutic agents in the fight against COVID-19; considering that no food or supplement has been authorized to prevent COVID-19, individuals continue to search for and consume specific herbs, foods, and commercial supplements for this purpose. This study will be aimed to estimate the uses of herbal and natural products during the COVID-19 infection to determine their usage reasons and evaluate their potential side effects. An online cross-sectional survey of different participants will be conducted and will be a focus on respondents’ chronic disease histories, socio-dmographic characteristics, and frequency and trends of using these products. Descriptive and univariate analyses will be performed to determine prevalence and associations between various products used and respondents’ socio-demographic data. Relationships will be tested using Pearson’s chi-square test or an exact probability test. Our main findings will give evidence of beneficial uses of natural products and herbal medicine as prophylactic and will be a vigorous approach to stop or at least slow down COVID-19 infection and transmission. This will be of great interest of public health, and the results of our study will lend health officials better control on the current pandemic.

Keywords: COVID-19, herbs, natural products, saudi arabia

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Authors: Chatcai Tangsri, Onjaree Na-Takuatoong

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This paper aims to present the key factors that support the decision to use the technology and to present the knowledge transformation flow of visually impaired students after the use of virtual knowledge system as proposed as a new service innovation to universities in Thailand. Correspondents of 27 visually impaired students are involved in this research. Total of 25 students are selected from the University that mainly conducts non-classroom teaching environment; while another 2 visually impaired students are selected from classroom teaching environment. All of them are fully involved in the study along 8 weeks duration. All correspondents are classified into 5 small groups in various conditions. The research results revealed that the involvement from knowledge facilitator can push out for the behavioral actual use of the virtual knowledge system although there is no any developed intention to use behaviors. Secondly, the situations that the visually impaired students inadequate of the knowledge sources that usually provided by assistants i.e. peers, audio files etc. In this case, they will use the virtual knowledge system for both knowledge access and knowledge transfer request. With this evidence, the need of knowledge would play a stronger role than all technology acceptance factors. Finally, this paper revealed that the knowledge transfer in the normal method that students have a chance to physically meet up is still confirmed as their preference method. In term of other aspects of technology acceptance, it will be discussed together with challenges and recommendations at the end of this paper.

Keywords: knowledge system, visually impaired students, higher education, knowledge management enable technology, synchronous/asynchronous knowledge access, synchronous/asynchronous knowledge transfer

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Authors: F. Ghandehari, H. Lu, L. El-Jahel, D. Jayasuriya

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Disagreement among investors is a fundamental aspect of financial markets, significantly influencing market dynamics. Measuring this disagreement has traditionally posed challenges, often relying on proxies like analyst forecast dispersion, which are limited by biases and infrequent updates. Recent movements in social media indicate that retail investors actively seek financial advice online and can influence the stock market. The evolution of the investing landscape, particularly the rise of social media as a hub for financial advice, provides an alternative avenue for real-time measurement of investor sentiment and disagreement. Platforms like Reddit offer rich, community-driven discussions that reflect genuine investor opinions. This research explores how social media empowers retail investors and the potential of leveraging textual analysis of social media content to capture daily fluctuations in investor disagreement. This study investigates the relationship between daily investor disagreement and trading volume, focusing on the role of social media platforms in shaping market dynamics, specifically using data from WallStreetBets (WSB) on Reddit. This paper uses data from 2020 to 2023 from WSB and analyses 4,896 firms with enough social media activity in WSB to define stock-day level disagreement measures. Consistent with traditional theories that disagreement induces trading volume, the results show significant evidence supporting this claim through different disagreement measures derived from WSB discussions.

Keywords: disagreement, retail investor, social finance, social media

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Authors: Uche A. Nnawulezi

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Over the past decades, the acquisition and utilization of nuclear energy have remained a standout amongst the most intractable issues which past world leaders have unsuccessfully endeavored to grapple with. This study analyzes the present advancement and enactment on the acquisition and utilization of nuclear energy in contemporary international law. It seeks to address international co-operations in the field of nuclear energy by looking at what nuclear energy is all about and how it came into being. It also seeks to address concerns expressed by a few researchers on the position of nuclear law in the most extensive domain of the law by looking at the authoritative procedure for nuclear law, system of arrangements and traditions. This study also agrees in favour of treaty on non-proliferation of nuclear weapons based on human right and humanitarian principles that are not duly moral, but also legal ones. Specifically, the past development activities on nuclear weapon and the practical system of the nuclear energy institute will be inspected. The study noted among others, former president Obama's remark on nuclear energy and Pakistan nuclear policies and its attendant outcomes. Essentially, we depended on documentary evidence and henceforth scooped a great part of the data from secondary sources. The study emphatically advocates for the adoption of absolute liability principles and setting up of a viability trust fund, all of which will help in sustaining global peace where global best practices in acquisition and use of nuclear energy will be widely accepted in the contemporary international law. Essentially, the fundamental proposals made in this paper if completely adopted, might go far in fortifying the present advancement and enactment on the application and utilization of nuclear energy and accordingly, addressing a portion of the intractable issues under international law.

Keywords: nuclear energy, international law, acquisition, development

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Authors: Eric Berry White

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The paper examines the causality between solid waste pollution and lockdown. Particularly in 2020, the world experiences the takeover of the Corona virus pandemic, and most countries decided to adopt lockdown measure as the best solution to curtail the spread of the virus. On March 20, 2020, the Government of Liberia implemented a curfew that starts from 3:00PM to 6:00AM. This means that no unauthorized person is allowed to be in the streets during this time. In most developing countries, the issue of public waste and environmental hazard pollution tend to have a high effect among the slum communities where there are markets. This research covers 6 slums communities around the two biggest market hubs within Monrovia, and the result shows that the lockdown measure significantly reduced public waste pollution by reducing the movement of marketers in slum communities , where limited educational and sensitization for young people is reflected on their job market exclusion, jobless circle, and youth workforce concentration in informal work market. The study discovered that with public awareness and sensitization with females, solid waste could be reduced by 13 percentage point. But there is no evidence that awareness among male conduce pollution. within affected communities, Despite the impact of the lockdown on food consumption, these results emphasized that with the right monitoring of waste and aware, pollution could be reduce. By understanding these results and implementing the best policy, the paper recommends that dump sites be close at certain hours.

Keywords: lockdown, environmental, pollution, waste

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Authors: Nunthawan Nowwarote, Waleerat Sukarawan, Prasit Pavasant, Thanaphum Osathanon

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Interleukin 6 (IL-6) is a multifunctional cytokine, regulating various biological responses in several tissues. A Recent study shows that IL-6 plays a role in stemness maintenance in stem cells isolated from human exfoliated deciduous teeth (SHEDs). However, the role of IL-6 on cell differentiation in SHEDs remains unknown. The present study investigated the effect of IL-6 on SHEDs differentiation. Cells were isolated from dental pulp tissues of human deciduous teeth. Flow cytometry was used to determined mesenchymal stem cell marker expression, and the multipotential differentiation (osteogenic, adipogenic and neurogenic lineage ) was also determined. The mRNA was determined using real-time quantitative polymerase chain reaction, and the phenotypes were confirmed by chemical and immunofluorescence staining. Results demonstrated that SHEDs expressed CD44, CD73, CD90, CD105 but not CD45. Further, the up-regulation of osteogenic, adipogenic and neurogenic marker genes was observed upon maintaining cells in osteogenic, adipogenic and neurogenic induction medium, respectively. The addition of IL-6 induced osteogenic by up-regulated osteogenic marker gene also increased in vitro mineralization. Under neurogenic medium supplement with IL-6, up-regulated neurogenic marker. Whereas, an addition of IL-6 attenuated adipogenic differentiation by SHEDs. In conclusion, this evidence implies that IL-6 may participate in cells differentiation ability of SHEDs.

Keywords: SHEDs, IL-6, cell differentiations, dental pulp

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Authors: Abraham J. Rizkalla, Joanne F. Irons, Christopher Q. Cao

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Purpose: Lobectomy was considered the standard of care for early-stage non-small lung cancer (NSCLC) after the Lung Cancer Study Group trial demonstrated increased locoregional recurrence for sublobar resections. However, there has been heightened interest in segmentectomies for selected patients with peripheral lesions ≤2cm, as investigated by the JCOG0802 and CALGB140503 trials. Minimally invasive robotic surgery facilitates segmentectomies with improved maneuverability and visualization of intersegmental planes using indocyanine green. We hereby present a patient who underwent robotic lingulectomy for an undiagnosed ground-glass opacity. Methodology: This video demonstrates a robotic portal lingulectomy using three 8mm ports and a 12mm port. Stereoscopic direct vision facilitated the identification of the lingula artery and vein, and intra-operative bronchoscopy was performed to confirm the lingula bronchus. The intersegmental plane was identified by indocyanine green and a near-infrared camera. Thorough lymph node sampling was performed in accordance with international standards. Results: The 18mm lesion was successfully excised with clear margins to achieve R0 resection with no evidence of malignancy in the 8 lymph nodes sampled. Histopathological examination revealed lepidic predominant adenocarcinoma, pathological stage IA. Conclusion: This video presentation exemplifies the standard approach for robotic portal lingulectomy in appropriately selected patients.

Keywords: lung cancer, robotic segmentectomy, indocyanine green, lingulectomy

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Authors: Viktoriia Malinovska, Iryna Kuklina, Katerina Grabicova, Milos Buric, Pavel Kozak

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Personal care products, including organic UV filters, are considered emerging contaminants and their toxic effects have been a concern for the last decades. Sunscreen compounds continually enter the surface waters via sewage water treatment due to incomplete removal and during human recreational and laundry activities. Despite the environmental occurrence of organic UV filters in the freshwater environment, little is known about their impacts on aquatic biota. In this study, environmentally relevant concentrations of 5-Benzoyl-4-hydroxy-2-methoxybenzenesulfonic acid (BP-4, 2.5 µg/L) and 2-Phenylbenzimidazole-5-sulfonic acid (PBSA, 3 µg/L) were used to evaluate the cardiac and locomotor responses of signal crayfish Pacifastacus leniusculus during a short time period. The effects of these compounds were evident in experimental animals. Specimens exposed to both tested compounds exhibited significantly bigger changes in distance moved and time movement than controls. Significant differences in changes in mean heart rate were detected in both PBSA and BP-4 experimental groups compared to control groups. Such behavioral and physiological alterations demonstrate the ecological effects of selected sunscreen compounds during a short time period. Since the evidence of the impacts of sunscreen compounds is scarce, the knowledge of how organic UV filters influence aquatic organisms is of key importance for future research.

Keywords: aquatic pollutants, behavior, freshwaters, heart rate, invertebrate

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Authors: E. Kempen, M. J. Labuschagne, M. P. Jama

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There is evidence that experiential learning is truly influential and favored by the millennial generation. However, little is known about the role and attributes an educator has to adopt during the experiential learning cycle, especially when applied in optometry education. This study aimed to identify the roles and attributes of an optometry educator during the different modes of the experiential learning cycle. Methods: A qualitative case study design was used. Data was collected using an open-ended questionnaire survey, following the application of nine different teaching-learning methods based on the experimental learning cycle. The total sample population of 68 undergraduate students from the Department of Optometry at the University of the Free State, South Africa were invited to participate. Focus group interviews (n=15) added additional data that contributed to the interpretation and confirmation of the data obtained from the questionnaire surveys. Results: The perceptions and experiences of the students identified a variety of roles and attributes as well as recommendations on the effective adoption of these roles and attributes. These roles and attributes included being knowledgeable, creating an interest, providing guidance, being approachable, building confidence, implementing ground rules, leading by example, and acting as a mediator. Conclusion: The findings suggest that the actions of an educator have the most substantial impact on students’ perception of a learning experience. Not only are the recommendations based on the views of a millennial generation, but the implementation of the personalized recommendations may also transform a learning environment. This may lead an optometry student to a deeper understanding of knowledge.

Keywords: experiences and perceptions, experiential learning, millennial generation, recommendation for optometry education

Procedia PDF Downloads 116