Search results for: pregnancy outcomes

Authors: Ziara Carmelli G. Tan, Irene Carmelle S. Tan

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Background: Trichotillomania (TTM) and Major Depressive Disorder (MDD) are two psychiatric conditions that frequently co-occur, presenting a significant challenge for treatment due to their complex interplay. TTM involves repetitive hair-pulling, leading to noticeable hair loss and distress, while MDD is characterized by persistent low mood and loss of interest or pleasure, leading to dysfunctionality. This case report examines the intricate relationship between TTM and MDD in a young adult female, emphasizing the need for a comprehensive, multifaceted therapeutic approach to address both disorders effectively. Case Presentation: The patient is a 21-year-old female college student and youth church leader who presented with chronic hair-pulling and depressive symptoms. Her premorbid personality was marked by low self-esteem and a strong need for external validation. Despite her academic and social responsibilities and achievements, she struggled with managing her emotional distress, which was exacerbated by her family dynamics and her role within her church community. Her hair-pulling and mood symptoms were particularly triggered by self-esteem threats and feelings of inadequacy. She was diagnosed with Trichotillomania, Scalp and Major Depressive Disorder. Intervention/Management: The patient’s treatment plan was comprehensive, incorporating both pharmacological and non-pharmacological interventions. Initial pharmacologic management was Fluoxetine 20mg/day up, titrated to 40mg/day with no improvement; hence, shifted to Escitalopram 20mg/day and started with N-acetylcysteine 600mg/day with noted significant improvement in symptoms. Psychotherapeutic strategies played a crucial role in her treatment. These included supportive-expressive psychodynamic psychotherapy, which helped her explore and understand underlying emotional conflicts. Cognitive-behavioral techniques were employed to modify her maladaptive thoughts and behaviors. Grief processing was integrated to help her cope with significant losses. Family therapy was done to address conflicts and collaborate with the treatment process. Psychoeducation was provided to enhance her understanding of her condition and to empower her in her treatment journey. A suicide safety plan was developed to ensure her safety during critical periods. An interprofessional approach, which involved coordination with the Dermatology service for co-management, was also a key component of her treatment. Outcome: Over the course of 15 therapy sessions, the patient demonstrated significant improvement in both her depressive symptoms and hair-pulling behavior. Her active engagement in therapy, combined with pharmacological support, facilitated better emotional regulation and a more cohesive sense of self. Her adherence to the treatment plan, along with the collaborative efforts of the interprofessional team, contributed to her positive outcomes. Discussion: This case underscores the significance of addressing both TTM and its comorbid conditions to achieve effective treatment outcomes. The intricate interplay between TTM and MDD in the patient’s case highlights the importance of a comprehensive treatment plan that includes both pharmacological and psychotherapeutic approaches. Supportive-expressive psychodynamic psychotherapy, Cognitive-behavioral techniques, and Family therapy were particularly beneficial in addressing the complex emotional and behavioral aspects of her condition. The involvement of an interprofessional team, including dermatology co-management, was crucial in providing holistic care. Future practice should consider the benefits of such a multidisciplinary approach to managing complex cases like this, ensuring that both the psychological and physiological aspects of the disorders are adequately addressed.

Keywords: cognitive-behavioral therapy, interprofessional approach, major depressive disorder, psychodynamic psychotherapy, trichotillomania

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Authors: Yamam Abuzinadah

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Mental health literacy has become a very influential topic around the world due to the increase of mental health issues that have been reported through national research and surveys. Mental health literacy refers to the awareness, attitudes, beliefs, knowledge and skills when dealing with mental illness. This research explores mental health literacy in the Arabic and the ways culture informs perceptions of mental health in general. Also, the impact of mental health literacy on: help-seeking attitudes, relationships and community interactions. The outcomes of this research will contribute to raising mental health awareness among the Arabic community, develop and enhance mental health service provision and explore new ideas in regards to elevating mental health literacy in the Arabic community. This research aims to explore attitudes, beliefs, perspective, values and perceptions toward mental health in general among the Arabic community. It will also aim to highlight the factors contributing to theses beliefs, perspective, value and perception and accordingly the role these factors play in regards to awareness, services access, recovery and care provided from the family and the community. This thesis will aim to reflect a detailed theorisation and exploration of: (1) The impact of cultural factors on mental health literacy ie. attitudes, beliefs, knowledge and skills. (2) The ways culture informs perceptions of mental health literacy. (3) The impact of mental health literacy on: help-seeking behaviors, and relationships and community interactions.

Keywords: Arab, mental health, literacy, awareness

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Authors: Shan Li, Qiuwen Ma

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Integrated project delivery (IPD) is a project delivery method distinguished by a shared risk/rewards mechanism and multiparty agreement. IPD has drawn increasing attention from construction industry due to its reliability to deliver high-performing buildings. However, unavailable IPD specific insurance concerns the industry participants who are interested in IPD implementation. Even though the risk management capability can be enhanced using shared risk mechanism, some risks may occur when the partners do not commit themselves into the integrated practices in a desired manner. This is because the intense collaboration and close integration can not only create added value but bring new opportunistic behaviors and disputes. The study is aimed to investigate the risks of implementing IPD using Bayesian theory. IPD risk taxonomy is presented to identify all potential risks of implementing IPD and a risk network map is developed to capture the interdependencies between IPD risks. The conditional relations between risk occurrences and the impacts of IPD risks on project performances are evaluated and simulated based on Bayesian theory. The probability of project outcomes is predicted by simulation. In addition, it is found that some risks caused by integration are most possible occurred risks. This study can help the IPD project participants identify critical risks of adopting IPD to improve project performances. In addition, it is helpful to develop IPD specific insurance when the pertinent risks can be identified.

Keywords: Bayesian theory, integrated project delivery, project risks, project performances

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Authors: Neneng Hayatul Milah

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The most important reading skill for students is comprehension. Understanding the reading text will have an impact on learning outcomes. However, reading comprehension instruction in Indonesian elementary schools is lacking. A more effective learning model is needed to enhance students' reading comprehension. This study aimed to evaluate the effectiveness of the CIRC (Cooperative Integrated Reading and Composition) model with Padlet integration in improving the reading comprehension skills of grade IV students in elementary schools in Cimahi City, Indonesia. This research methodology was quantitative with a pre-experiment research type and one group pretest-posttest research design. The sample of this study consisted of 30 students. The results of statistical analysis showed that there was a significant effect of using the CIRC learning model using Padlet on improving students' reading comprehension skills of narrative text. The mean score of students' pretest was 67.41, while the mean score of the posttest increased to 84.82. The paired sample t-test resulted in a t-count score of -13.706 with a significance score of <0.001, which is smaller than α = 0.05. This research is expected to provide useful insights for educational practitioners on how the use of the CIRC model using Padlet can improve the reading comprehension skills of elementary school students.

Keywords: reading comprehension skills, CIRC, Padlet, narrative text

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Authors: Amani K. Abu-Shaheen, Abdullah Nofal, Humariya Heena

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Introduction: Parental perceptions and practices are important for improving the asthma outcomes in children; indeed, evidence shows that parents of asthmatic children harbor considerable misperceptions of the disease. Objective: To identify the prevalence of asthma and to investigate the perceptions and practices of parents toward asthma and its management in Saudi children. Methods: A two-stage cross-sectional survey of 2000 parents of children aged 3–15 years from schools located in all five districts of Riyadh province located in central Saudi Arabia, was conducted. Data collection was accomplished using a self-administered questionnaire based on information obtained from the literature. Results: Of 1450 children whose parents participated in the study, 600 had asthma, dyspnea, or chest allergy. The overall number of children with parental reports of ever having been diagnosed with asthma was 478 (32.9%). The majority of parents (321, 53.5%) believed that asthma was a hereditary disease. Of these parents, 361 (60.3%) were concerned about side effects of inhaled steroids, and 192 (32%) about development of dependency on asthma medications. Three hundred sixty seven (61.2%) parents reported that they could treat the asthma attack at home and almost 76% of parents went to pediatric emergency department during asthma attack. Conclusions: In this study, the overall prevalence of children whose parents reported that they were diagnosed with asthma was high (32.9%). Furthermore, parents of children with asthma had misperceptions regarding asthma and exhibited ineffective practices in its management. To improve asthma care and compliance, adequate education should be provided to parents.

Keywords: asthma, management, parents, quality of life

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Authors: Maha Salah, Hanaa Hashem, Mahmoud M. Alsagheir, Mohammed Salah

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Acute respiratory distress syndrome (ARDS) represents a complex clinical syndrome and carries a high risk for mortality. The severity of the clinical course, the uncertainty of the outcome, and the reliance on the full spectrum of critical care resources for treatment mean that the entire health care team is challenged. Researchers and clinicians have investigated the nature of the pathological process and explored treatment options with the goal of improving outcome. Through this application of research to practice, we know that some previous strategies have been ineffective, and innovations in mechanical ventilation, sedation, nutrition, and pharmacological intervention remain important research initiatives. Developed Clinical pathway is multidisciplinary plans of best clinical practice for this specified groups of patients that aid in the coordination and delivery of high quality care. They are a documented sequence of clinical interventions that help a patient to move, progressively through a clinical experience to a desired outcome. Although there is a lot of heterogeneity in patients with ARDS, this suggested developed clinical pathway with alternatives was built depended on a lot of researches and evidence based medicine and nursing practices which may be helping these patients to improve outcomes, quality of life and decrease mortality.

Keywords: acute respiratory distress syndrome (ARDS), clinical pathway, clinical syndrome

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Authors: Fernanda Conforto de Oliveira

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The International Monetary Fund (IMF) has a central role in global financial governance as the world’s leading crisis lender. Its practice of conditional lending – conditioning loans on the implementation of economic policy adjustments – is the primary lever by which the institution interacts with and influences the policy choices of member countries and has been a key topic of interest to scholars and public opinion. However, empirical evidence about the economic and (geo)political determinants of IMF lending behavior remains inconclusive, and no model that explains IMF policies has been identified. This research moves beyond panel analysis to focus on financial negotiations for the first IMF programs in Argentina and Brazil in the early post-war period. It seeks to understand why negotiations achieved distinct objectives: Argentinean officials cooperated and complied with IMF policies, whereas their Brazilian counterparts hesitated. Using qualitative and automated text analysis, this paper analyses the hypothesis about whether a differential IMF treatment could help to explain these distinct outcomes. This paper contributes to historical studies on IMF-Latin America relations and the broader literature in international policy economy about IMF policies.

Keywords: international monetary fund, international history, financial history, Latin American economic history, natural language processing, sentiment analysis

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Authors: Meryem Saban Guler, Saniye Bilici

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Malnutrition is a problem that significantly affects patients with cancer throughout the course of their illness, and it may be present from the moment of diagnosis until the end of treatment. We searched electronic databases using key terms such as ‘malnutrition in cancer patients’ or ‘nutritional status in cancer’ or ‘nutritional screening tools’ etc. Decline in nutritional status and continuing weight loss are associated with an increase in number and severity of complications, impaired quality of life and decreased survival rate. Nutrition is an important factor in the treatment and progression of cancer. Cancer patients are particularly susceptible to nutritional depletion due to the combined effects of the malignant disease and its treatment. With increasing incidence of cancer, identification and management of nutritional deficiencies are needed. Early identification of malnutrition, is substantial to minimize or prevent undesirable outcomes throughout clinical course. In determining the nutritional status; food consumption status, anthropometric methods, laboratory tests, clinical symptoms, psychosocial data are used. First-line strategies must include routine screening and identification of inpatients or outpatients at nutritional risk with the use of a simple and standardized screening tool. There is agreement among international nutrition organizations and accredited health care organizations that routine nutritional screening should be a standard procedure for every patient admitted to a hospital. There are f management of all cancer patients therefore routine nutritional screening with validated tools can identify cancer patients at risk.

Keywords: cancer, malnutrition, nutrition, nutritional screening

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Authors: Oladejo Olagoke Peter, Adagunodo T. A., Ogunkoya C. O.

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The research investigated the arrangement of some geological features under Ilesa employing aeromagnetic data. The obtained data was subjected to various data filtering and processing techniques, which are Total Horizontal Derivative (THD), Depth Continuation and Analytical Signal Amplitude using Geosoft Oasis Montaj 6.4.2 software. The Reduced to the Equator –Total Magnetic Intensity (TRE-TMI) outcomes reveal significant magnetic anomalies, with high magnitude (55.1 to 155 nT) predominantly at the Northwest half of the area. Intermediate magnetic susceptibility, ranging between 6.0 to 55.1 nT, dominates the eastern part, separated by depressions and uplifts. The southern part of the area exhibits a magnetic field of low intensity, ranging from -76.6 to 6.0 nT. The lineaments exhibit varying lengths ranging from 2.5 and 16.0 km. Analyzing the Rose Diagram and the analytical signal amplitude indicates structural styles mainly of E-W and NE-SW orientations, particularly evident in the western, SW and NE regions with an amplitude of 0.0318nT/m. The identified faults in the area demonstrate orientations of NNW-SSE, NNE-SSW and WNW-ESE, situated at depths ranging from 500 to 750 m. Considering the divergence magnetic susceptibility, structural style or orientation of the lineaments, identified fault and their depth, these lithological features could serve as a valuable foundation for assessing ground motion, particularly in the presence of sufficient seismic energy.

Keywords: lineament, aeromagnetic, anomaly, fault, magnetic

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Authors: Benjamin Cramer, Josephine Chau, Helen Little, Erica Randle

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Play Streets provide a safe and open space for children to play and adults to socialize by closing residential streets to through traffic. While research on Play Streets has typically focused on physical activity outcomes in children, there is limited research on the psychosocial health externalities for the wider community. Charles Sturt, a local government area in Adelaide, South Australia, has been hosting Play Streets for several years. The current study is a mixed-methods evaluation of the Charles Sturt Play Streets, concerned with the perceived psychological and social impacts that Play Streets impact on the community. A combination of semi-structured interviews of Play Street organizers and participants will be conducted and analyzed using inductive thematic analysis. Pre-existing survey data will also be analyzed quantitatively and qualitatively to triangulate the findings of the qualitative interviews. The implications of this research are far-reaching, from informing local councils of any additional health benefits of Play Streets, expanding the growing literature on Play Streets beyond childhood physical activity, informing the development of city infrastructure, and advancing the Sustainability Development Goals of Good Health and Wellbeing, Reduced Inequalities, and Sustainable Cities and Communities.

Keywords: play streets, mental health, social health, community health

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Authors: Zhenyu Yang, Qiunan Chen, Xiaocheng Huang

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Reliable prediction of tunnel collapse remains a prominent challenge in the field of civil engineering. In this study, leveraging the nonlinear Hoek-Brown failure criterion and the upper-bound theorem, an analytical solution for the collapse surface of shallowly buried circular tunnels was derived, taking into account the coupled effects of surface loads and pore water pressures. Initially, surface loads and pore water pressures were introduced as external force factors, equating the energy dissipation rate to the external force, yielding our objective function. Subsequently, the variational method was employed for optimization, and the outcomes were juxtaposed with previous research findings. Furthermore, we utilized the deduced equation set to systematically analyze the influence of various rock mass parameters on collapse shape and extent. To validate our analytical solutions, a comparison with prior studies was executed. The corroboration underscored the efficacy of our proposed methodology, offering invaluable insights for collapse risk assessment in practical engineering applications.

Keywords: tunnel roof stability, analytical solution, hoek–brown failure criterion, limit analysis

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Authors: Jitka Molnarova

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Based on De Soto’s idea that a formal land title can provide a secure home and access to credit to poor urban families, a large number of developing countries accepted the formalization of informal settlements as the ultimate solution for their housing crises and struggles with poverty. After two decades of implementation, very little is known about the effects this policy has on the quality of the neighborhoods it produces and on the development of cities in general. Using the capital of Peru -where the solution originated- as a case study, this paper illustrates the negative outcomes this policy has on urban development arguing that land titling encourages 1) expansion of the city often to areas of high physical risk, 2) production of precarious housing on unserviced land, and 3) practices of illegal land trafficking. The evidence is based on interviews with community leaders and officials working at the Cooperation for Formalization of Informal Property (COFOPRI), comparison of satellite images documenting the expansion of Lima in the past twenty years, and a technical evaluation of dozens of houses that have been or are in the process of being granted a land title.

Keywords: COFOPRI, De Soto, housing policies, land titling, land trafficking, Lima, Peru, precarious housing, urban expansion

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Authors: Diego F. Carrillo-González, Milena Osorio, Natalia M. Cerro, Yasser Y. Lenis

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Introduction: mortality during the implantation and early embryonic development periods reach around 30% in different mammalian species. It has been described that progesterone (P4) and Arginine (Arg) play a beneficial role in establishing and maintaining early pregnancy in mammals. The combined effect between Arg and P4 on reproductive parameters in the rabbit species is not yet elucidated, to our best knowledge. Objective: to assess the effect of L-arginine and progesterone during the post-breeding period in female rabbits on the composition of the amniotic fluid, the placental structure, and the bone growth in their fetuses. Methods: crossbred female rabbits (n=16) were randomly distributed into four experimental groups (Ctrl, Arg, P4, and Arg+P4). In the control group, 0.9% saline solution was administered as a placebo, the Arg group was administered arginine (50 mg/kg BW) from day 4.5 to day 19 post-breeding, the P4 group was administered progesterone (Gestavec®, 1.5 mg/kg BW) from 24 hours to day 4 post-breeding and for the Arg+P4 group, an administration was performed under the same time and dose guidelines as the Arg and P4 treatments. Four females were sacrificed, and the amniotic fluid was collected and analyzed with rapid urine test strips, while the placenta and fetuses were processed in the laboratory to obtain histological plates. The percentage of deciduous, labyrinthine, and junctional zones was determined, and the length of the femur for each fetus was measured as an indicator of growth. Descriptive statistics were applied to identify the success rates for each of the tests. Afterwards, A one-way analysis of variance (ANOVA) was performed, and a comparison of means was conducted by Tukey's test. Results: a higher density (p<0.05) was observed in the amniotic fluid for fetuses in the control group (1022±2.5g/mL) compared to the P4 (1015±5.3g/mL) and Arg+P4 (1016±4,9g/mL) groups. Additionally, the density of amniotic fluid in the Arg group (1021±2.5g/mL) was higher (p<0.05) than in the P4 group. The concentration of protein, glucose, and ascorbic acid had no statistical difference between treatments (p>0.05). The histological analysis of the uteroplacental regions, a statistical difference (p<0,05) in the proportion of deciduous zone was found between the P4 group (9.6±2.6%) when compared with the Ctrl (28.15±12.3%), and Arg+P4 (26.3±4.9) groups. In the analysis of the fetuses, the weight was higher for the Arg group (2.69±0.18), compared to the other groups (p<0.05), while a shorter length was observed (p<0.05) in the fetuses for the Arg+P4 group (25.97±1.17). However, no difference (p>0.05) was found when comparing the length of the developing femurs between the experimental groups. Conclusion: the combination of L-arginine and progesterone allows a reduction in the density of amniotic fluid, without affecting the protein, energy, and antioxidant components. However, the use of L-arginine stimulates weight gain in fetuses, without affecting size, which could be used to improve production parameters in rabbit production systems. In addition, the modification in the deciduous zone could show a placental adaptation based on the fetal growth process, however more specific studies on the placentation process are required.

Keywords: arginine, progesterone, rabbits, reproduction

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Authors: Sankalp Devanand, Prateek Agasimani, Shamith V. S., Rohith Neeraje

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Machine translation has witnessed significant advancements in recent years, but the translation of languages with distinct linguistic characteristics, such as English and Sanskrit, remains a challenging task. This research presents the development of a dedicated English-to-Sanskrit machine translation model, aiming to bridge the linguistic and cultural gap between these two languages. Using a variety of natural language processing (NLP) approaches, including FastText embeddings, this research proposes a thorough method to improve word meaning retrieval. Data preparation, part-of-speech tagging, dictionary searches, and transliteration are all included in the methodology. The study also addresses the implementation of an interpreter pattern and uses a word similarity task to assess the quality of word embeddings. The experimental outcomes show how the suggested approach may be used to enhance word meaning retrieval tasks with greater efficacy, accuracy, and adaptability. Evaluation of the model's performance is conducted through rigorous testing, comparing its output against existing machine translation systems. The assessment includes quantitative metrics such as BLEU scores, METEOR scores, Jaccard Similarity, etc.

Keywords: machine translation, English to Sanskrit, natural language processing, word meaning retrieval, fastText embeddings

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Authors: Seyed Hossein Iranmanesh, Hassan Nouri, Seyed Reza Iranmanesh

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In the dynamic and complex landscape of today’s business, organizations often face challenges in impactful decision-making across multi-project settings. To efficiently allocate resources, coordinate tasks, and optimize project outcomes, establishing robust decision-making processes is essential. Furthermore, the increasing importance of information systems and their integration within organizational workflows introduces an additional layer of complexity. This research proposes the use of blockchain technology as a suitable solution to enhance decision-making in multi-project environments, particularly within the realm of information systems. The conceptual framework in this study comprises four independent variables and one dependent variable. The identified independent variables for the targeted research include: Blockchain Layer in Integrated Systems, Quality of Generated Information ,User Satisfaction with Integrated Systems and Utilization of Integrated Systems. The project’s performance, considered as the dependent variable and moderated by organizational policies and procedures, reflects the impact of blockchain technology adoption on organizational effectiveness1. The results highlight the significant influence of blockchain implementation on organizational performance.

Keywords: multi-project environments, decision support systems, information systems, blockchain technology, decentralized systems.

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Authors: Medya Fathi

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Today, success in the construction industry is not merely about project completion in a timely manner within an established budget and meeting required quality considerations. Management practices and partnerships need to be emphasized as well. In this regard, critical success factors (CSFs) cover necessary considerations for a successful project beyond the traditional success definition, which vary depending on project outcomes, delivery methods, project types, and partnering processes. Despite the extensive research on CSFs, there is a paucity of studies that examine CSFs for public-private partnership (PPP); the delivery method, which has gained increasing attention from researchers and practitioners over the last decade with a slow but growing adoption in the transportation infrastructure, particularly, highway industry. To fill this knowledge gap, data are collected through questionnaire surveys among private and public parties involved in PPP transportation projects in the United States. Then, the collected data are analyzed to explore the causality relationships between CSFs and PPP project success using structural equation model and provide a list of factors with the greatest influence. This study advocates adopting a critical success factor approach to enhance PPP success in the U.S. transportation industry and identify elements essential for public and private organizations to achieve this success.

Keywords: project success, critical success factors, public-private partnership, transportation

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Authors: Ravinder Barn, Balbir Barn

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This paper outlines ethical and practical challenges in the building of social technology for use with socially excluded and marginalised groups. The primary aim of this study was to design, deploy and evaluate social technology that may help to promote better engagement between case workers and young people to help prevent recidivism, and support young people’s transition towards social inclusion in society. A total of 107 practitioners/managers (n=64), and young people (n=43) contributed to the data collection via surveys, focus groups and 1-1 interviews. Through a process of co-design where end-users are involved as key contributors to social technological design, this paper seeks to make an important contribution to the area of participatory methodologies by arguing that whilst giving ‘voice’ to key stakeholders in the research process is crucial, there is a risk that competing voices may lead to tensions and unintended outcomes. The paper is contextualized within a Foucauldian perspective to examine significant concepts including power, authority and surveillance. Implications for youth justice policy and practice are considered. The authors conclude that marginalized youth and over-stretched practitioners are better served when such social technology is perceived and adopted as a tool of empowerment within a framework of child welfare and child rights.

Keywords: youth justice, social technology, marginalization, participatory research, power

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Authors: Sanjida Ahmed Sinthia

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Bangladesh is one of the poorest countries in the world. There are several reasons for this insufficiency and uncontrolled population growth is one of the prime reasons. Others include low economic progress, imbalanced resource management, unemployment and underemployment, urban migration and natural catastrophes etc. As a result, the rate of urban poor is increasing inevitably in every sphere of urban cities in Bangladesh and Dhaka is the most affected one. Besides there is scarcity of urban land, housing, urban infrastructure and amenities which create pressure on urban cities and mostly encroach the open space, wetlands that causes environmental degradation. Government has no or limited control over these due to poor government policy and management, political pressure and lack of resource management. Unfortunately, over centralization and bureaucracy creates unnecessary delay and interruptions in any government initiations. There is also no coordination between government and private sector developer to solve the problem of urban Poor. To understand the problem of these huge populations this paper analyzes one of the single largest slum areas in Dhaka, Korail Slum. The study focuses on socio demographic analysis, morphological pattern and role of different actors responsible for the improvements of the area and recommended some possible steps for determining the potential outcomes.

Keywords: demographic analysis, environmental degradation, government policy, housing and land management policy

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Authors: Milda Istiqomah

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Deradicalization program has long been the subject of investigation. There is a steadily growing interest in examining the results on how Islamist terrorists agree to abandon violence and leave radicalism; however, it is argued that de-radicalization program on terrorism in many countries is still questionable for its effectiveness. This article aims to provide an overview of the deradicalization program specifically related to the victim-centred approach conducted by the Indonesian government and investigates critical issues surrounding the analysis of their effectiveness and outcomes. This research employs several case studies of a victim-centred approach conducted by the Indonesian Witness and Victim Protection Agency as well as the Indonesian Counter-terrorism Agency. This paper argues that the victim-centred approach to de-radicalize former terrorist prisoners faces several implemental challenges; however, the initiative may offer promise for future successful de-radicalization program. Furthermore, until more data surrounding the efficacy of this initiative available, the victim-centred approach may also constitute a significant and essential component of disengagement, de-radicalisation, and reintegration of terrorist prisoners. In conclusion, this paper suggests that further empirical research concerning prevention policies and disengagement interventions related to victim-centred approach need to be explored to give more inputs to the Indonesian government to achieve the effectiveness of de-radicalization program.

Keywords: terrorism, victim-centred approach, de-radicalization, Islamist extremism

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Authors: Jake Hindmarch, Edward Farley, Norman Eizenberg, Mark Midwinter

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There is a need to bring the anatomical knowledge of medical students up to the standards required by surgical specialties. Contention exists amongst anatomists, clinicians, and surgeons about the standard of anatomical knowledge medical students need. The aim of this study was to explore the standards which the Royal Australasian College of Surgeons are applying knowledge of anatomy. Furthermore, to align medical school teaching to what the surgical profession requires from graduates.: The 2018 volume of the ANZ Journal of Surgery was narrowed down to 254 articles by applying the search term “Anatomy”. The main topic was then extracted from each paper. The content of the paper was assessed for ‘novel description’ or ‘application’ of anatomical knowledge’ and classified accordingly. The majority of papers with an anatomical focus was from the general surgery specialty, which focused on surgical techniques, outcomes and management. Vascular surgery had the highest percentage of papers with a novel description and application of anatomy. Cardiothoracic and paediatric surgery had no papers with a novel description of anatomy. Finally, a novel application of anatomy was the main focus of each speciality. Firstly, a high proportion of novel applications and descriptions of anatomy are in general surgery. Secondly, vascular surgery had the largest proportion of novel application and description of anatomy, namely due to the rise of therapeutic imaging and endovascular techniques. Finally, all disciplines demonstrated a trend towards having a higher proportion of novel application of anatomical knowledge

Keywords: anatomical knowledge, anatomy, surgery, novel anatomy

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Authors: Abdul Qader Melhem, Hacene Badache

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This paper deals with the theoretical and experimental study of shear connection via simple steel reinforcement shear connectors, which are steel reinforcing bars bent into L-shapes, instead of commonly used headed studs. This suggested L-shape connectors are readily available construction material in steel reinforcement. The composite section, therefore, consists of steel inverted T-section being embedded within a lightly reinforced concrete flange at the top slab as a unit. It should be noted that the cross section of these composite models involves steel inverted T-beam, replacing the steel top flange of a standard commonly employed I-beam section. The paper concentrates on the elastic and elastic-plastic behavior of these composite models. Failure modes either by cracking of concrete or shear connection be investigated in details. Elastic and elastoplastic formulas of the composite model have been computed for different locations of NA. Deflection formula has been derived, its value was close to the test value. With a supportive designing curve, this curve is valuable for both designing engineers and researchers. Finally, suggested designing curves and valuable equations will be presented. A check is made between theoretical and experimental outcomes.

Keywords: composite, elastic-plastic, failure, inverted T-section, L-Shape connectors

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Authors: Joella Mukashyaka, Rose Mukarubayiza, Emmanuel Habumugisha, Francois-Xavier Sunday, Kellen Muganwa, Valens Mbarushimana, Pamela Meharry

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Background: Breastfeeding in the first hour post-birth can decrease neonatal morbidity and mortality. Disease prevention and health outcomes differ immensely between newborns who receive human milk and those who do not. Rwanda has high breastfeeding rates, though factors associated with early initiation of breastfeeding (EIBF) are unknown. Objective: To assess factors associated with EIBF among mothers in immediate postpartum units at two hospitals. Methods: A cross-sectional study design and a convenience sample of 187 mothers were used. An interviewer-administered questionnaire was used for data collection. A Chi-square test showed the relationship between EIBF and sociodemographic factors. Results: The findings showed less than one quarter (20.5%) breastfed within the first hour after birth. The majority was < 25 years (52.4%), had some primary education (27.7%) employed (66.7%), urban dweller (58.1%), attendance of one ANC visit or more (81.3%), vaginal birth (58.8%), and did not receive EIBF health education (92.0%). The majority (78.5%) was too tired to initiate breastfeeding, and many supplemented (41.9%) due to perceived insufficient breastmilk. Conclusion: Most mothers did not initiate breastfeeding within the first hour after birth. Sociodemographic factors were associated with EIBF. A program to promote, protect, and support EIBF is urgently needed the community.

Keywords: breastfeeding, early initiation, neonates, morbidity, mortality, sub-Saharan Africa

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Authors: Soraya Abtouche, Zeyneb Ghoualem, Syrine Daoudi, Lina Ouldmohamed, Xavier Assfeld

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This work reports density functional theory calculations of the optimized geometries, molecular reactivity, energy gap,and thermodynamic properties of the free base (H2P) and their Zn (II) metallated (ZnP), bearing one, two, or three carboxylic acid groups using the hybrid functional B3LYP, Cam-B3lYP, wb97xd with 6-31G(d,p) basis sets. When donating groups are attached to the molecular dye, the bond lengths are slightly decreased, which is important for the easy transfer of an electron from donating to the accepting group. For all dyes, the highest occupied molecular orbital/lowest occupied molecular orbital analysis results in positive outcomes upon electron injection to the semiconductor and subsequent dye regeneration by the electrolyte. The ionization potential increases with increasing conjugation; therefore, the compound dye attached to one carboxylic acid group has the highest ionization potential. The results show higher efficiencies of those sensitized with ZnP. These results have been explained, taking into account the electronic character of the metal ion, which acts as a mediator in the injection step, and, on the other hand, considering the number of anchoring groups to which it binds to the surface of TiO2.

Keywords: DSSC, porphyrin, TD-DFT, electronic properties, donor-acceptor groups

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Authors: T. L. Granzyk, S. Scarborough, J. DeCosmo

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The use of health-related or medical narratives has gained increasing anecdotal and research-based support as a successful device for changing health behavior and outcomes. These narratives, in the form of oral storytelling, short films, and educational documentaries, for example, are most effective when including empathetic characters that transport viewers into the story and command both their attention and emotional response. This case study outlines how and why one large health system created a short narrative film for their internal Sepsis Awareness campaign, which told the dramatic story of a patient recovering from a missed sepsis diagnosis, leaving her a quad-amputee. Results include positive global anecdotal response to the film from healthcare professionals and patients, as well as use of the film to support legislation, ultimately passed in favor of the formation of Sepsis Awareness Workgroups in Maryland. Authors conclude that narrative films can be used successfully to initiate healthcare legislation and to increase internal and external awareness of health-related areas in need of greater improvement and support. As such, healthcare leaders and stakeholders would benefit from learning how to intentionally create, cultivate, and curate narratives from within their own health systems that elicit an empathetic response.

Keywords: healthcare policy, healthcare narratives, sepsis awareness, short films

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Authors: Kai Yip Michael Tsang

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Science writing has played a crucial part in science assessments. This paper reports a study in an area that has received little research attention – how Language across the Curriculum (LAC, i.e. science language and literacy) learning activities in science lessons can increase the science knowledge development of English as a foreign language (EFL) students in Hong Kong. The data comes from a school-based interventional study in chemistry classrooms, with written data from questionnaires, assessments and teachers’ logs and verbal data from interviews and classroom observations. The effectiveness of the LAC teaching and learning activities in various chemistry classrooms were compared and evaluated, with discussion of some implications. Students in the treatment group with lower achieving students received LAC learning and teaching activities while students in the control group with higher achieving students received conventional learning and teaching activities. After the study, they performed better in control group in formative assessments. Moreover, they had a better attitude to learning chemistry content with a richer language support. The paper concludes that LAC teaching and learning activities yielded positive learning outcomes among chemistry learners with low English ability.

Keywords: science learning and teaching, content and language integrated learning, language across the curriculum, English as a foreign language

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Authors: Cinthia G. P. Calou, Franz J. Antezana, Ana I. O. Nicolau, Eveliny S. Martins, Paula R. A. L. Soares, Glauberto S. Quirino, Dayanne R. Oliveira, Priscila S. Aquino, Régia C. M. B. Castro, Ana K. B. Pinheiro

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Introduction: As an integral part of the health-disease process, gestation is a period in which the social insertion of women can influence, in a positive or negative way, the course of the pregnancy-puerperal cycle. Thus, evaluating the quality of life of this population can redirect the implementation of innovative practices in the quest to make them more effective and real for the promotion of a more humanized care. This study explores the associations between the obstetric factors with affected areas of health-related quality of life of pregnant women with habitual risk. Methods: This is a cross-sectional, quantitative study conducted in three public facilities and a private service that provides prenatal care in the city of Fortaleza, Ceara, Brazil. The sample consisted of 261 pregnant women who underwent low-risk prenatal care and were interviewed from September to November 2014. The collection instruments were a questionnaire containing socio-demographic and obstetric variables, in addition to the Brazilian version of the Mother scale Generated Index (MGI) characterized by being a specific and objective instrument, consisting of a single sheet and subdivided into three stages. It allows identifying the areas of life of the pregnant woman that are most affected, which could go unnoticed by the pre-formulated measurement instruments. The obstetric data, as well as the data concerning the application of the MGI scale, were compiled and analyzed through the statistical program Statistical Package for the Social Sciences (SPSS), version 20.0. After the compilation, a descriptive analysis was carried out. Then, associations were made between some variables. The tests applied were the Pearson Chi-Square and the Fisher's exact test. The odds ratio was also calculated. These associations were considered statistically significant when the p (probability) value was less than or equal to a level of 5% (α = 0.05) in the tests performed. Results: The variables that negatively reflected the quality of life of the pregnant women and presented a significant association with the polaciuria were: gestational age (p = 0.022) and parity (p = 0.048). Episodes of nausea and vomiting also showed significant with gestational age correlation (p = 0.0001). Evaluating the crossing of stress, we observed a significant association with parity (p = 0.0001). In turn, emotional lability revealed dependence on the variable type of delivery (p = 0.009). Conclusion: The health professionals involved in the assistance to the pregnant woman can understand how the process of gestation is experienced, considering all its peculiar transformations; to meet their individual needs, stimulating their autonomy and their power of choice, envisaging the achievement of a better quality of life related to health in the perspective of health promotion.

Keywords: health-related quality of life, obstetric nursing, pregnant women, prenatal care

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Authors: Mohammad Javad Behzadnia, Hamidreza Javadzadeh

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Background: Pain management is essential to surmounting multi-injured people in an overcrowded emergency setting. Its role would be more apparent when the physician encounters a mass casualty in a war zone or even a military prehospital. Having sedative and analgesic properties, rapid onset and offset effects, and maintaining the cardiovascular and respiratory contain are the main reason for selecting Ketamine as a good choice in the war zone. Methods: In a prospective interventional study in a war zone, we have selected and followed two groups of casualties for pain management. All were men with an average age of 26.6±8 y/o and 27.5 ±7 y/o in A and B groups, respectively. Group A received only Ketamine and Group B received Ketamine and diazepam. Results: This study showed that all of the injured patients who received Ketamine had experienced some agitation, and they may finally need benzodiazepines for sedation, but in group B that received benzodiazepine before or simultaneous with Ketamine, the agitation was significantly reduced. (P Value ≤0.05) Conclusion: Various factors may affect pain score and perception; patients' culture, mental health, previous drug usage, and addiction could alter the pain score in similar situations. It seems that the significant agitation is due to catecholamine release in stressful Moments of the battlefield. Accordingly, this situation could be exacerbated due to ketamine properties. Nonetheless, as a good choice in the war zone, Ketamine is now recommended to combine with benzodiazepines for procedural sedation and analgesia (PSA).

Keywords: battlefield, ketamine, benzodiazepine, pain control

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Authors: Debasish Pradhan, Shaktiprasad Pradhan, Rakesh Kumar Pradhan, Gitanjali Tripathy

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Suppressors of cytokine signalling (SOCS1), a newly indentified antiapoptotic molecule is a downstream effector of the receptor tyrosine kinase-Ras signalling pathway. The current study has uncovered that SOCS1 may have wide and imperative capacities, particularly because of its close correlation with malignant tumors. To investigate the impact of SOCS1 on MDR, we analyzed the expression of P-gp and SOCS1 by immunohistochemistry and found there was a positive correlation between them. At that point, we effectively interfered with RNA translation by the contamination of siRNA of SOCS1 into MCF7/ADM breast cancer cell lines through a lentivirus, and the expression of the target gene was significantly inhibited. After RNAi, the drug resistance was reduced altogether and the expression of MDR1 mRNA and P-gp in MCF7/ADM cell lines demonstrated a significant decrease. Likewise, the expression of P53 protein increased in a statistically significant manner (p ≤ 0.01) after RNAi exposure. Moreover, flow cytometry analysis uncovers that cell cycle and anti-apoptotic enhancing capacity of cells changed after RNAi treatment. These outcomes proposed SOCS1 may take part in breast cancer MDR by managing MDR1 and P53 expression, changing cell cycle and enhancing the anti-apoptotic ability.

Keywords: breast cancer, multidrug resistance, SOCS1 gene, MDR1 gene, RNA interference

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Authors: Amina Sultan, Mohamed Ghonim, Eman Oweida, Aya Abdelaziz

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Objective: To assess the diagnostic reliability of multi-detector CT in pre and post-operative evaluation of cochlear implant candidates. Material and Methods: The study includes 40 patients (18 males and 22 females); mean age 5.6 years. They were classified into two groups: Group A (20 patients): cochlear implant device was Nucleus-22 and Group B (20 patients): the device was MED-EL. Cochlear length (CL) and cochlear height (CH) were measured pre-operatively by 128-multidetector CT. Electrode length (EL) and insertion depth angle (α) were measured post-operatively by MDCT. Results: For Group A mean CL was 9.1 mm ± 0.4 SD; mean CH was 4.1 ± 0.3 SD; mean EL was 18 ± 2.7 SD; mean α angle was 299.05 ± 37 SD. Significant statistical correlation (P < 0.05) was found between preoperative CL and post-operative EL (r²=0.6); as well as EL and α angle (r²=0.7). Group B's mean CL was 9.1 mm ± 0.3 SD; mean CH was 4.1 ± 0.4 SD; mean EL was 27 ± 2.1 SD; mean α angle was 287.6 ± 41.7 SD. Significant statistical correlation was found between CL and EL (r²= 0.6) and α angle (r²=0.5). Also, a strong correlation was found between EL and α angle (r²=0.8). Significant statistical difference was detected between the two devices as regards to the electrode length. Conclusion: Multidetector CT is a reliable tool for preoperative planning and post-operative evaluation of the outcomes of cochlear implant operations. Cochlear length is a valuable prognostic parameter for prediction of the depth of electrode array insertion which can influence criteria of device selection.

Keywords: angle of insertion (α angle), cochlear implant (CI), cochlear length (CL), Multidetector Computed Tomography (MDCT)

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Authors: Misbah Khan, Jian Wen, Muhammad Asif Shakoori

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The Organic Rankine Cycle (ORC) plays an important role in converting low-temperature heat sources into electrical power by using refrigerants as working fluids. The thermophysical properties of working fluids are essential for designing ORC. HFO-1336mzz(Z) (cis-1,1,1,4,4,4-hexafluoro-2-butene) considered as working fluid and have almost 99% low GWP and relatively same thermophysical properties used as a replacement of HFC-245fa (1,1,1,3,3-pentafluoro-propane). The environmental, safety, healthy and thermophysical properties of HFO-1336mzz(Z) are needed to use it in a practical system. In this paper, Molecular dynamics simulations were used to investigate the Homogeneous condensation, thermophysical and structural properties of HFO-1336mzz(Z) and HFC-245fa. The effect of various temperatures and pressures on thermophysical properties and condensation was extensively investigated. The liquid densities and isobaric heat capacities of this refrigerant was simulated at 273.15K to 353.15K temperatures and pressure0.5-4.0MPa. The simulation outcomes were compared with experimental data to validate our simulation method. The mean square displacement for different temperatures was investigated for dynamical analysis. The variations in potential energies and condensation rate were simulated to get insight into the condensation process. The radial distribution function was simulated at the micro level for structural analysis and revealed that the phase transition of HFO-1336mzz(Z) did not affect the intramolecular structure.

Keywords: homogenous condensation, refrigerants, molecular dynamics simulations, organic rankine cycle

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