Search results for: middle adult

Authors: Matthew Scott Lau

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This study addresses the research question: How effective has the Community Health Assist Scheme (CHAS) been in reducing market failure in Singapore’s healthcare sector? The CHAS policy, introduced in 2012 in Singapore, aims to improve accessibility and affordability of healthcare by offering subsidies to low and middle-income groups and elderly individuals for general practice consultations and healthcare. The investigation was undertaken by acquiring and analysing primary and secondary research data from 3 main sources, including handwritten survey responses of 334 individuals who were valid CHAS subsidy recipients (CHAS cardholders) from 5 different locations in Singapore, interview responses from two established general practitioner doctors with working knowledge of the scheme, and information from literature available online. Survey responses were analysed to determine how CHAS has affected the affordability and consumption of healthcare, and other benefits or drawbacks for CHAS users. The interview responses were used to explain the benefits of healthcare consumption and provide different perspectives on the impacts of CHAS on the various parties involved. Online sources provided useful information on changes in healthcare consumerism and Singapore’s government policies. The study revealed that CHAS has been largely effective in reducing market failure as the subsidies granted to consumers have improved the consumption of healthcare. This has allowed for the external benefits of healthcare consumption to be realized, thus reducing market failure. However, the study also revealed that CHAS cannot be fully effective in reducing market failure as the scope of CHAS prevents healthcare consumption from fully reaching the socially optimal level. Hence, the study concluded that CHAS has been effective to a large extent in reducing market failure in Singapore’s healthcare sector, albeit with some benefits to third parties yet to be realised. There are certain elements of the investigation, which may limit the validity of the conclusion, such as the means used to determine the socially optimal level of healthcare consumption, and the survey sample size.

Keywords: healthcare consumption, health economics, market failure, subsidies

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Authors: Tracey Lion-Cachet

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Eating disorders typically manifest in adolescence and are notoriously difficult to treat. There are two notable reasons for this. Firstly, research consistently demonstrates that early intervention is a critical mediator of prognosis, with early intervention leading to a better prognosis. However, because eating disorders do not originate as full-syndrome diagnoses but rather as prodromal cases, they often go undetected; by the time symptoms meet diagnostic criteria, they have become recalcitrant. Another interrelated issue is motivation to change. Research demonstrates that in the early stages of an eating disorder, adolescents are highly resistant to change, and motivation increases only once symptoms have shifted from egosyntonic to egodystonic in nature. The purpose of this project was to design a prevention model based on the social psychology paradigm of Entertainment-Education, which embeds messages within the genre of film as a means of affecting change. The resulting project was a narrative screenplay targeting teenagers/young adults from diverse backgrounds. The goals of the project were to create a film script that, if ultimately made into a film, could serve to: 1) interrupt symptom progression and improve prognosis through early intervention; 2) incorporate techniques from third-wave cognitive behavioral treatment models, acceptance and commitment therapy (ACT) and rational recovery (RR), with a focus on the effects of mindfulness as a means of informing recovery; 3) target issues to do with motivation to change by shifting the perception of eating disorders from culturally specific psychiatric illnesses to habit-based brain wiring issues. Nine licensed clinicians were asked to evaluate two excerpts taken from the final script. They subsequently provided feedback on a Likert-scale, which assessed whether the script had achieved its goals. Overall, evaluators agreed that the project’s etiological and intervention models have the potential to inspire change and serve as an effective means of prevention and treatment of eating disorders. However, one-third of the evaluators did not find the content developmentally appropriate. This is a notable limitation to the study and will need to be addressed in the larger script before the final project can potentially be targeted to a teenage and young adult audience.

Keywords: adolescents, eating disorders, pediatrics, entertainment-education, mindfulness-based intervention, prevention

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Authors: Venera Goxha

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Property and inheritance rights for women whose husbands were killed or disappeared during the last war in Kosovo is the purpose of this study, respectively, the access of these women to family real estate. The case study is about women whose husbands were killed or disappeared during the last war in Kosovo and who, on this occasion, earned the title of 'widow'.The research is conducted in the villages of Krusha e Vogël - Municipality of Prizren, and Krusha e Madhe - Municipality of Rahovec, one of the most suffered villages from the recent war in Kosovo. Krusha e Vogël, as a result of the recent war, has 113 male victims, or 70% of all men from the age of 13 to the age of 77, leaving widows and orphans. In the village of Krusha e Madhe, 243 Albanians were massacred by Serbs living in the same village, leaving widows and orphaned children alive. According to these data, most of the Krushian families, as heads of households, have surviving wives and widows. Therefore, being the head of the family and facing a mountain of challenges, such as economic, social, and cultural, the issue of how these women have approached the property and family heritage is considered. The equal right to property and inheritance is a right that is guaranteed to women with all legislation in force, starting from the Constitution of the Republic of Kosovo onwards. Article 7 of the Constitution of Kosovo and the subsequent legal framework recognizes the equality of women and the equal division of property between heirs, daughters, and sons. However, some of the legislation does not successfully reflect the current reality in Kosovo. All these ambiguities follow from the ‘patriarchal law’ of the Albanians in the time of the early Middle Ages, later known as the ‘Kanun of Lekë Dukagjini’. At the time it was written and applied, it weighted the law in force, but later over time, it passed into tradition, culture, and mentality. The Kanun of Lekë Dukagjini, in no context, has treated women equally to men. The female, according to the Kanun, was a working tool, a creature to be born, to work, to carry, to raise children, and to remain faithful to the husband even when the husband is not faithful.

Keywords: property rights, heritage, widows, code

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Authors: Tamara Tallman

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Collaboration is a powerful tool for professional development and central for creating opportunities for teachers to reflect on their practice. However, school districts continue to have difficulty both implementing and sustaining collaboration. The purpose of this research was to investigate the experience of the teacher in a creative, instructional collaboration. The teachers in this study found that teacher-initiated collaboration offered them trust and they were more open with their partners. An interpretative phenomenological analysis was used for this study as it told the story of the teacher’s experience. Interpretative Phenomenological Analysis was chosen for this study to capture the complex and contextual nature of the teacher experience from a creative, instructional collaborative experience. This study sought to answer the question of how teachers in a private, faith-based school experience collaboration. In particular, the researcher engaged the study’s participants in interviews where they shared their unique perspectives on their experiences in relation to this phenomenon. Through the use of interpretative phenomenological analysis, the researcher interpreted the experiences of each participant in an attempt to gain deeper insight into how teachers made sense of their understanding of collaboration. In addition to the researcher’s interpreting the meaning of this construct for each research participant, this study gave a voice to the individual experiences and positionality of each participant at the research site. Moreover, the key findings presented in this study shed light on how teachers within this particular context participated in and made sense of their experience of creating an instructional collaborative. The research presented the findings that speak to the meaning that each research participant experienced in their relation to participating in building a collaborative culture and its effect on professional and personal growth. The researcher provided recommendations for future practice and research possibilities. The research findings demonstrated the unique experiences of each participant as well as a connection to the literature within the field of teacher professional development. The results also supported the claim that teacher collaboration can facilitate school reform. Participating teachers felt less isolation and developed more teacher knowledge.

Keywords: collaboration, personal grwoth, professional development, teachers

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Authors: Chalachew Gashu, Yoseph Kassa, Habtamu Geremew, Mengestie Mulugeta

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Background and Aims: Severe acute malnutrition remains a significant health challenge, particularly in low‐ and middle‐income countries. The aim of this study was to determine the survival time of under‐five children with severe acute malnutrition. Methods: A retrospective cohort study was conducted at a hospital, focusing on under‐five children with severe acute malnutrition. The study included 322 inpatients admitted to the Chiro hospital in Chiro, Ethiopia, between September 2019 and August 2020, whose data was obtained from medical records. Survival functions were analyzed using Kaplan‒Meier plots and log‐rank tests. The survival time of severe acute malnutrition was further analyzed using the Cox proportional hazards model and Bayesian parametric survival models, employing integrated nested Laplace approximation methods. Results: Among the 322 patients, 118 (36.6%) died as a result of severe acute malnutrition. The estimated median survival time for inpatients was found to be 2 weeks. Model selection criteria favored the Bayesian Weibull accelerated failure time model, which demonstrated that age, body temperature, pulse rate, nasogastric (NG) tube usage, hypoglycemia, anemia, diarrhea, dehydration, malaria, and pneumonia significantly influenced the survival time of severe acute malnutrition. Conclusions: This study revealed that children below 24 months, those with altered body temperature and pulse rate, NG tube usage, hypoglycemia, and comorbidities such as anemia, diarrhea, dehydration, malaria, and pneumonia had a shorter survival time when affected by severe acute malnutrition under the age of five. To reduce the death rate of children under 5 years of age, it is necessary to design community management for acute malnutrition to ensure early detection and improve access to and coverage for children who are malnourished.

Keywords: Bayesian analysis, severe acute malnutrition, survival data analysis, survival time

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Authors: Paul Kipchumba

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Kenya is an East African Country lying at the Equator. It had a population of 46 million in 2015 with an annual growth rate of 2.7%, making a population of at least 65 million in 2030. Kenya’s GDP in 2015 was about 63 billion USD with per capita GDP of about 1400 USD. The rural population is 74%, whereas urban population is 26%. Kenya grapples with not only access to energy but also with energy security. There is direct correlation between economic growth, population growth, and energy consumption. Kenya’s energy composition is at least 74.5% from renewable energy with hydro power and geothermal forming the bulk of it; 68% from wood fuel; 22% from petroleum; 9% from electricity; and 1% from coal and other sources. Wood fuel is used by majority of rural and poor urban population. Electricity is mostly used for lighting. As of March 2015 Kenya had installed electricity capacity of 2295 MW, making a per capital electricity consumption of 0.0499 KW. The overall retail cost of electricity in 2015 was 0.009915 USD/ KWh (KES 19.85/ KWh), for installed capacity over 10MW. The actual demand for electricity in 2015 was 3400 MW and the projected demand in 2030 is 18000 MW. Kenya is working on vision 2030 that aims at making it a prosperous middle income economy and targets 23 GW of generated electricity. However, cost and non-cost factors affect generation and consumption of electricity in Kenya. Kenya does not care more about CO2 emissions than on economic growth. Carbon emissions are most likely to be paid by future costs of carbon emissions and penalties imposed on local generating companies by sheer disregard of international law on C02 emissions and climate change. The study methodology was a simulated application of carbon tax on all carbon emitting sources of electricity generation. It should cost only USD 30/tCO2 tax on all emitting sources of electricity generation to have solar as the only source of electricity generation in Kenya. The country has the best evenly distributed global horizontal irradiation. Solar potential after accounting for technology efficiencies such as 14-16% for solar PV and 15-22% for solar thermal is 143.94 GW. Therefore, the paper recommends adoption of solar power for generating all electricity in Kenya in order to attain zero carbon electricity generation in the country.

Keywords: co2 emissions, cost factors, electricity generation, non-cost factors

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Authors: H. Akhloufi, M. Hulscher, J. M. Prins, I. H. Van Der Sijs, D. Melles, A. Verbon

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Background: A timely switch from intravenous to oral antibiotic therapy has many advantages, such as reduced incidence of IV-line related infections, a decreased hospital length of stay and less workload for healthcare professionals with equivalent patient safety. Additionally, numerous studies have demonstrated significant decreases in costs of a timely intravenous to oral antibiotic therapy switch, while maintaining efficacy and safety. However, a considerable variation in iv to oral antibiotic switch therapy criteria has been described in literature. Here, we report the development of a set of iv to oral switch criteria that are generally applicable in all hospitals. Material/methods: A RAND-modified Delphi procedure, which was composed of 3 rounds, was used. This Delphi procedure is a widely used structured process to develop consensus using multiple rounds of questionnaires within a qualified panel of selected experts. The international expert panel was multidisciplinary and composed out of clinical microbiologists, infectious disease consultants and clinical pharmacists. This panel of 19 experts appraised 6 major intravenous to oral antibiotic switch therapy criteria and operationalized these criteria using 41 measurable conditions extracted from the literature. The procedure to select a concise set of iv to oral switch criteria included 2 questionnaire rounds and a face-to-face meeting. Results: The procedure resulted in the selection of 16 measurable conditions, which operationalize 6 major intravenous to oral antibiotic switch therapy criteria. The following 6 major switch therapy criteria were selected: (1) Vital signs should be good or improving when bad. (2) Signs and symptoms related to the infection have to be resolved or improved. (3) The gastrointestinal tract has to be intact and functioning. (4) The oral route should not be compromised. (5) Absence of contra-indicated infections. (6) An oral variant of the antibiotic with good bioavailability has to exist. Conclusions: This systematic stepwise method which combined evidence and expert opinion resulted in a feasible set of 6 major intravenous to oral antibiotic switch therapy criteria operationalized by 16 measurable conditions. This set of early antibiotic iv to oral switch criteria can be used in daily practice in all adult hospital patients. Future use in audits and as rules in computer assisted decision support systems will lead to improvement of antimicrobial steward ship programs.

Keywords: antibiotic resistance, antibiotic stewardship, intravenous to oral, switch therapy

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Authors: Dana El-Mughayyar, Neil Manson, Erin Bigney, Eden Richardson, Dean Tripp, Edward Abraham

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Use of narcotics to treat pain has increased over the past two decades and is a contributing factor to the current public health crisis. Understanding the pre-operative risks of chronic narcotic use may be aided through investigation of psychological measures. The objective of the reported study is to determine predictors of narcotic use two years post-surgery in a thoracolumbar spine surgery population, including an array of psychological factors. A prospective observational study of 191 consecutively enrolled adult patients having undergone thoracolumbar spine surgery is presented. Baseline measures of interest included the Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia, Multidimensional Scale for Perceived Social Support (MSPSS), Chronic Pain Acceptance Questionnaire (CPAQ-8), Oswestry Disability Index (ODI), Numeric Rating Scales for back and leg pain (NRS-B/L), SF-12’s Mental Component Summary (MCS), narcotic use and demographic variables. The post-operative measure of interest is narcotic use at 2-year follow-up. Narcotic use is collapsed into binary categories of use and no use. Descriptive statistics are run. Chi Square analysis is used for categorical variables and an ANOVA for continuous variables. Significant variables are built into a hierarchical logistic regression to determine predictors of post-operative narcotic use. Significance is set at α < 0.05. Results: A total of 27.23% of the sample were using narcotics two years after surgery. The regression model included ODI, NRS-Leg, time with condition, chief complaint, pre-operative drug use, gender, MCS, PCS subscale helplessness, and CPAQ subscale pain willingness and was significant χ² (13, N=191)= 54.99; p = .000. The model accounted for 39.6% of the variance in narcotic use and correctly predicted in 79.7% of cases. Psychological variables accounted for 9.6% of the variance over and above the other predictors. Conclusions: Managing chronic narcotic usage is central to the patient’s overall health and quality of life. Psychological factors in the preoperative period are significant predictors of narcotic use 2 years post-operatively. The psychological variables are malleable, potentially allowing surgeons to direct their patients to preventative resources prior to surgery.

Keywords: narcotics, psychological factors, quality of life, spine surgery

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Authors: Ghasem Yazdanpanah, Mona Kakavand, Hassan Niknejad

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Objectives: An important issue in tissue engineering (TE) is hemocompatibility. The current engineered vessels are seriously at risk of thrombus formation and stenosis. Amnion (AM) is the innermost layer of fetal membranes that consists of epithelial and mesenchymal sides. It has the advantages of low immunogenicity, anti-inflammatory and anti-bacterial properties as well as good mechanical properties. We recently introduced the amnion as a natural biomaterial for tissue engineering. In this study, we have evaluated hemocompatibility of amnion as potential biomaterial for tissue engineering. Materials and Methods: Amnions were derived from placentas of elective caesarean deliveries which were in the gestational ages 36 to 38 weeks. Extracted amnions were washed by cold PBS to remove blood remnants. Blood samples were obtained from healthy adult volunteers who had not previously taken anti-coagulants. The blood samples were maintained in sterile tubes containing sodium citrate. Plasma or platelet rich plasma (PRP) were collected by blood sample centrifuging at 600 g for 10 min. Hemocompatibility of the AM samples (n=7) were evaluated by measuring of activated partial thromboplastin time (aPTT), prothrombin time (PT), hemolysis, and platelet aggregation tests. P-selectin was also assessed by ELISA. Both epithelial and mesenchymal sides of amnion were evaluated. Glass slide and expanded polytetrafluoroethylene (ePTFE) samples were defined as control. Results: In comparison with glass as control (13.3 ± 0.7 s), prothrombin time was increased significantly while each side of amnion was in contact with plasma (p<0.05). There was no significant difference in PT between epithelial and mesenchymal surfaces (17.4 ± 0.7 s vs. 15.8 ± 0.7 s, respectively). However, aPPT was not significantly changed after incubation of plasma with amnion epithelial and mesenchymal surfaces or glass (28.61 ± 1.39 s, 31.4 ± 2.66 s, glass, 30.76 ± 2.53 s, respectively, p>0.05). Amnion surfaces, ePTFE and glass samples have less hemolysis induction than water considerably (p<0.001), in which no differences were detected. Platelet aggregation measurements showed that platelets were less stimulated by the amnion epithelial and mesenchymal sides, in comparison with ePTFE and glass. In addition, reduction in amount of p-selectin, as platelet activation factor, after incubation of samples with PRP indicated that amnion has less stimulatory effects on platelets than ePTFE and glass. Conclusion: Amnion as a natural biomaterial has the potential to be used in tissue engineering. Our results suggest that amnion has appropriate hemocompatibility to be employed as a vascular substitute.

Keywords: amnion, hemocompatibility, tissue engineering, biomaterial

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Authors: Md. Khayrul Bashar, Md. Saiful Islam, Kimiko Yamashita, Yano Midori

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Despite having some progress in human authentication, conventional biometrics (e.g., facial features, fingerprints, retinal scans, gait, voice patterns) are not robust against falsification because they are neither confidential nor secret to an individual. As a non-invasive tool, electrocardiogram (ECG) has recently shown a great potential in human recognition due to its unique rhythms characterizing the variability of human heart structures (chest geometry, sizes, and positions). Moreover, ECG has a real-time vitality characteristic that signifies the live signs, which ensure legitimate individual to be identified. However, the detection accuracy of the current ECG-based methods is not sufficient due to a high variability of the individual’s heartbeats at a different instance of time. These variations may occur due to muscle flexure, the change of mental or emotional states, and the change of sensor positions or long-term baseline shift during the recording of ECG signal. In this study, a new method is proposed for human identification, which is based on the extraction of the local roughness of ECG heartbeat signals. First ECG signal is preprocessed using a second order band-pass Butterworth filter having cut-off frequencies of 0.00025 and 0.04. A number of local binary patterns are then extracted by applying a moving neighborhood window along the ECG signal. At each instant of the ECG signal, the pattern is formed by comparing the ECG intensities at neighboring time points with the central intensity in the moving window. Then, binary weights are multiplied with the pattern to come up with the local roughness description of the signal. Finally, histograms are constructed that describe the heartbeat signals of individual subjects in the database. One advantage of the proposed feature is that it does not depend on the accuracy of detecting QRS complex, unlike the conventional methods. Supervised recognition methods are then designed using minimum distance to mean and Bayesian classifiers to identify authentic human subjects. An experiment with sixty (60) ECG signals from sixty adult subjects from National Metrology Institute of Germany (NMIG) - PTB database, showed that the proposed new method is promising compared to a conventional interval and amplitude feature-based method.

Keywords: human identification, ECG biometrics, local roughness patterns, supervised classification

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Authors: Abdalla Mohamed M. Musbahi

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The study area lies in Al-Falah area on Airport-Tripoli in Zone (16) Where planned establishment of complex multi-floors for residential and commercial, this part was divided into seven subzone. In each sup zone, were collected Orthogonal profiles by using Seismic refraction method. The overall aim with this project is to investigate the applicability of Seismic refraction method is a commonly used traditional geophysical technique to determine depth-to-bedrock, competence of bedrock, depth to the water table, or depth to other seismic velocity boundaries The purpose of the work is to make engineers and decision makers recognize the importance of planning and execution of a pre-investigation program including geophysics and in particular seismic refraction method. The overall aim with this thesis is achieved by evaluation of seismic refraction method in different scales, determine the depth and velocity of the base layer (bed-rock). Calculate the elastic property in each layer in the region by using the Seismic refraction method. The orthogonal profiles was carried out in every subzones of (zone 16). The layout of the seismic refraction set up is schematically, the geophones are placed on the linear imaginary line whit a 5 m spacing, the three shot points (in beginning of layout–mid and end of layout) was used, in order to generate the P and S waves. The 1st and last shot point is placed about 5 meters from the geophones and the middle shot point is put in between 12th to 13th geophone, from time-distance curve the P and S waves was calculated and the thickness was estimated up to three-layers. As we know any change in values of physical properties of medium (shear modulus, bulk modulus, density) leads to change waves velocity which passing through medium where any change in properties of rocks cause change in velocity of waves. because the change in properties of rocks cause change in parameters of medium density (ρ), bulk modulus (κ), shear modulus (μ). Therefore, the velocity of waves which travel in rocks have close relationship with these parameters. Therefore we can estimate theses parameters by knowing primary and secondary velocity (p-wave, s-wave).

Keywords: application of seismic, geotechnical study, physical properties, seismic refraction

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Authors: Ansoné Human, Nantes Kirsten, Tanja Verster, Willem D. Schutte

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Every year the telecommunications industry suffers huge losses due to fraud. Mobile fraud, or generally, telecommunications fraud is the utilisation of telecommunication products or services to acquire money illegally from or failing to pay a telecommunication company. A South African telecommunication operator developed two internal fraud scorecards to mitigate future risks of application fraud events. The scorecards aim to predict the likelihood of an application being fraudulent and surprise fraudsters before they surprise the telecommunication operator by identifying fraud at the time of application. The scorecards are utilised in the vetting process to evaluate the applicant in terms of the fraud risk the applicant would present to the telecommunication operator. Telecommunication providers can utilise these scorecards to profile customers, as well as isolate fraudulent and/or high-risk applicants. We provide the complete methodology utilised in the development of the scorecards. Furthermore, a Determination and Discrimination (DD) ratio is provided in the methodology to select the most influential variables from a group of related variables. Throughout the development of these scorecards, the following was revealed regarding fraudulent cases and fraudster behaviour within the telecommunications industry: Fraudsters typically target high-value handsets. Furthermore, debit order dates scheduled for the end of the month have the highest fraud probability. The fraudsters target specific stores. Applicants who acquire an expensive package and receive a medium-income, as well as applicants who obtain an expensive package and receive a high income, have higher fraud percentages. If one month prior to application, the status of an account is already in arrears (two months or more), the applicant has a high probability of fraud. The applicants with the highest average spend on calls have a higher probability of fraud. If the amount collected changes from month to month, the likelihood of fraud is higher. Lastly, young and middle-aged applicants have an increased probability of being targeted by fraudsters than other ages.

Keywords: application fraud scorecard, predictive modeling, regression, telecommunications

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Authors: Hanbyul Kim, Hye-Jin Kin, Taehun Park, Woo Jun Sul, Susun An

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Skin is the largest organ of the human body and can provide the diverse habitat for various microorganisms. The ecology of the skin surface selects distinctive sets of microorganisms and is influenced by both endogenous intrinsic factors and exogenous environmental factors. The diversity of the bacterial community in the skin also depends on multiple host factors: gender, age, health status, location. Among them, age-related changes in skin structure and function are attributable to combinations of endogenous intrinsic factors and exogenous environmental factors. Skin aging is characterized by a decrease in sweat, sebum and the immune functions thus resulting in significant alterations in skin surface physiology including pH, lipid composition, and sebum secretion. The present study gives a comprehensive clue on the variation of skin microbiota and the correlations between ages by analyzing and comparing the metagenome of skin microbiome using Next Generation Sequencing method. Skin bacterial diversity and composition were characterized and compared between two different age groups: younger (20 – 30y) and older (60 - 70y) Xian, Chinese women. A total of 73 healthy women meet two conditions: (I) living in Xian, China; (II) maintaining healthy skin status during the period of this study. Based on Ribosomal Database Project (RDP) database, skin samples of 73 participants were enclosed with ten most abundant genera: Chryseobacterium, Propionibacterium, Enhydrobacter, Staphylococcus and so on. Although these genera are the most predominant genus overall, each genus showed different proportion in each group. The most dominant genus, Chryseobacterium was more present relatively in Young group than in an old group. Similarly, Propionibacterium and Enhydrobacter occupied a higher proportion of skin bacterial composition of the young group. Staphylococcus, in contrast, inhabited more in the old group. The beta diversity that represents the ratio between regional and local species diversity showed significantly different between two age groups. Likewise, The Principal Coordinate Analysis (PCoA) values representing each phylogenetic distance in the two-dimensional framework using the OTU (Operational taxonomic unit) values of the samples also showed differences between the two groups. Thus, our data suggested that the composition and diversification of skin microbiomes in adult women were largely affected by chronological and physiological skin aging.

Keywords: next generation sequencing, age, Xian, skin microbiome

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Authors: Mariana Floria, Elena-Diana Năfureanu, Diana-Mihaela Gălăţanu, Anca-Ecaterina Grumeza, Cristina Gorea-Bocîncă, Diana-Elena Iov, Aurelian-Corneliu Moraru, Dragoș-Marian Popescu

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SARS-CoV-2 is the most deadly and devastating virus of the last one hundred years, being more highly contagious than EBOLA, HIV, Swine Influenza, Severe Acute Respiratory Syndrome, or Middle Eastern Respiratory Syndrome. After two years of pandemic, planning and budgeting for use of healthcare resources and services is very important. The aim of this study was to analyze the costs for hospital stay in patients with predominantly moderate forms of COVID-19 in a support military hospital located in Nord-East of Romania. Inpatient COVID-19 hospitalizations costs, regardless of ICD-10 procedure codes (DRG payment), in a Covid-19 support military hospital were analyzed. From August 2020 through June 2021, 241 patientswere hospitalized. Our national protocol for the treatment of Covid-19 infection was applied. The main COVID-19 manifestations were: 69% respiratory (18% with severe pneumonia, 2.9% with pulmonary embolism, diagnosed by angio-computed tomography), 3.3% cardiac, 28% digestive, and 33% psychiatric (most common anxiety) manifestations. According to COVID-19 severity, most of the patients had moderate (104 patients – 43%) and severe (50 patients - 21%) forms. Seven patients with severe form died because of multiple comorbidities, and 30 patients were transferred in hospitals with COVID-19 intensive care units.Only two patients have had procalcitonin>10 ng/mL (high probability of severe sepsis or septic shock), and 1 patient had moderate risk for septic shock (0.5 - 2 ng/mL). The average estimated costs were about 3000€/patient, without significantly differences depending on disease severity. Equipment costs were 2 times higher than for drugs and 4 times than for laboratory tests. In a Covid-19 support military hospital that took care for predominantly moderate forms of COVID-19, the costs for equipment were much higher than that for treatment. Therefore, new criteria for hospitalization of these forms of COVID-19 deserve to be analyzed to avoid useless costs.

Keywords: Covid-19, costs, hospital stay, military hospital

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Authors: Ira Irawati, Muhammad Rangga Sururi

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The expansion of built-up areas in many cities, particularly, as the consequences of urbanization process, is a common phenomenon in our contemporary world. As happened in many cities in developing world, this horizontal expansion let only a handful size of the area left for green open spaces, creating an extreme unbalance between built-up and green spaces. Combined with the high density and variety of human activities with its transportation modes; a process of urban heat island will occur, resulting in an increase in air temperature. This is one of the indicators of decreasing of the quality of urban microclimate. This paper will explore the effect of several variables of built-up areas and open spaces to the increase of air temperature using multiple linear regression analysis. We selected 11 zones within the radius of 1 km in Inner Bandung city center, and each zones measured within 300 m radius to represent the variety of land use, as well as the composition of buildings and green open spaces. By using a quantitative method which is multiple linear regression analysis, six dependent variables which are a) tree density-x1, b) shade level of tree-x2, c) surface area of buildings’ side which are facing west and east-x3, d) surface area of building side material-x4, e) surface area of pathway material, and f) numbers of motorized vehicles-x6; are calculated to find those influence to the air temperature as an independent variable-y. Finally, the relationship between those variables shows in this equation: y = 30.316 - 3.689 X1 – 6.563 X2 + 0.002 X3 – 2,517E6 X4 + 1.919E-9 X5 + 1.952E-4 X6. It shows that the existence of vegetation has a great impact on lowering temperature. In another way around, built up the area and motorized vehicles would increase the temperature. However, one component of built up area, the surface area of buildings’ sides which are facing west and east, has different result due to the building material is classified in low-middle heat capacity.

Keywords: built-up area, microclimate, vehicles, urban heat island, vegetation

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Authors: Yun Chan Lee

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Background: End-of-life care is a large area of all nursing practice and student nurses are likely to meet dying patients in many placement areas. It is therefore important to understand the emotional responses and coping strategies of student nurses in order for nursing education systems to have some appreciation of how nursing students might be supported in the future. Methodology: This research used a qualitative phenomenological approach. Six student nurses understanding a degree-level adult nursing course were interviewed. Their responses to questions were analyzed using interpretative phenomenological analysis. Finding: The findings identified 3 main themes. First, the common experience of ‘unpreparedness’. A very small number of participants felt that this was unavoidable and that ‘no preparation is possible’, the majority felt that they were unprepared because of ‘insufficient input’ from the university and as a result of wider ‘social taboos’ around death and dying. The second theme showed that emotions were affected by ‘the personal connection to the patient’ and the important sub-themes of ‘the evoking of memories’, ‘involvement in care’ and ‘sense of responsibility’. The third theme, the coping strategies used by students, seemed to fall into two broad areas those ‘internal’ with the student and those ‘external’. In terms of the internal coping strategies, ‘detachment’, ‘faith’, ‘rationalization’ and ‘reflective skills’ are the important components of this part. Regarding the external coping strategies, ‘clinical staff’ and ‘the importance of family and friends’ are the importance of accessing external forms of support. Implication: It is clear that student nurses are affected emotionally by caring for dying patients and many of them have apprehension even before they begin on their placements but very often this is unspoken. Those anxieties before the placement become more pronounced during and continue after the placements. This has implications for when support is offered and possibly its duration. Another significant point of the study is that participants often highlighted their wish to speak to qualified nurses after their experiences of being involved in end-of-life care and especially when they had been present at the time of death. Many of the students spoke that qualified nurses were not available to them. This seemed to be due to a number of reasons. Because the qualified nurses were not available, students had to make use of family members and friends to talk to. Consequently, the implication of this study is not only to educate student nurses but also to educate the qualified mentors on the importance of providing emotional support to students.

Keywords: nursing students, coping strategies, end-of-life care, emotional responses

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Authors: Mehmet Uysal, Yavuz Arat, Uğur Tuztaşı

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As man constructed the spaces that he lived in he also designed spaces where their dead will stay according to their belief systems. These spaces are sometimes monumentalized by the means of a stone on the top of a mountain, sometimes signed by totems and sometimes became structures to protect graves and symbolize the person or make him unforgettable. Various grave monuments have been constructed from the earliest primitive societies to developed societies. Every belief system built structures for itself; Pyramids for pharaohs, grave monuments for kings and emperors, temples and tombs for important men of religion. These spaces are also architectural works like a school or a dwelling and have importance in history of architecture. After Turks embraced Islamism, examples of very beautiful tombs are built in Middle Asia during the Seljuk Period. By the time Seljuks came to Anatolia they built important tombs having peerless architectural characteristics firstly around Ahlat. After Anatolia Seljuks made Konya the capital city and Konya became administrative, cultural and scientific center, very important tombs were built in Konya. Different from the local tomb architecture, the architecture of tombs with half-open “eyvan/Iwan” is significant. Although iwan buildings is vastly used in Anatolian civil architecture and monumental buildings its best exmaples are observed in 13th century Medrese buildings. The iwan tomb tradition which was observed during the time period when this building typology was shaped and departed from the resident tradition in the form of iwan tombs are rarely represented. However, similar tombs were build in resemblance to this tradition. This study provides information on samples of iwan tombs (Gömeç Hatun Tomb, Emir Yavaştagel Tomb, and Beşparmak Tomb) and evaluates the departures from iwan building complexes in view of architectural language. This paper also gives information about iwan tombs among tombs having importance in Islamic Architectural Heritage.

Keywords: Seljuk Building Complex, Eyvan/Iwan, Anatolia, Islamic Architectural Heritage, tomb

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Authors: Rose Mini Agoes Salim, Shahnaz Safitri

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The aim of this study is to test the effectiveness of teaching kindness in preschool children by using several techniques. Kindness is a physical act or emotional support aimed to build or maintain relationships with others. Kindness is known to be essential in the development of moral reasoning to distinguish between the good and bad things. In this study, kindness is operationalized as several acts including helping friends, comforting sad friends, inviting friends to play, protecting others, sharing, saying hello, saying thank you, encouraging others, and apologizing. It is mentioned that kindness is crucial to be developed in preschool children because this is the time the children begin to interact with their social environment through play. Furthermore, preschool children's cognitive development makes them begin to represent the world with words, which then allows them to interact with others. On the other hand, preschool children egocentric thinking makes them still need to learn to consider another person's perspective. In relation to social interaction, preschool children need to be stimulated and assisted by adult to be able to pay attention to other and act with kindness toward them. On teaching kindness to children, the quality of interaction between children and their significant others is the key factor. It is known that preschool children learn about kindness by imitating adults on their two way interaction. Specifically, this study examines two types of teaching techniques that can be done by parents as a way to teach kindness, namely the picture-storybook reading and hand-puppet storytelling. These techniques were examined because both activities are easy to do and both also provide a model of behavior for the child based on the character in the story. To specifically examine those techniques effectiveness in teaching kindness, two studies were conducted. Study I involves 31 children aged 5-6 years old with picture-storybook reading technique, where the intervention is done by reading 8 picture books for 8 days. In study II, hand-puppet storytelling technique is examined to 32 children aged 3-5 years old. The treatments effectiveness are measured using an instrument in the form of nine colored cards that describe the behavior of kindness. Data analysis using Wilcoxon Signed-rank test shows a significant difference on the average score of kindness (p < 0.05) before and after the intervention has been held. For daily observation, a ‘kindness tree’ and observation sheets are used which are filled out by the teacher. Two weeks after interventions, an improvement on all kindness behaviors measured is intact. The same result is also gained from both ‘kindness tree’ and observational sheets.

Keywords: kindness, moral teaching, storytelling, hand puppet

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Authors: S. Malebary, W. Xu

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Antennas are important components that enable transmitting and receiving signals in mid-air (wireless). The radiation pattern of omni-directional (i.e., dipole) antennas, reflects the variation of power radiated by an antenna as a function of direction when transmitting. As the performance of the antenna is the same in transmitting and receiving, it also reflects the sensitivity of the antenna in different directions when receiving. The main observation when dealing with omni-directional antennas, regardless the application, is they equally radiate power in all directions in reference to Equivalent Isotropically Radiated Power (EIRP). Disseminating radio frequency signals in an omni-directional manner form a doughnut-shape-field with a cone in the middle of the elevation plane (when mounted vertically). In this paper, we investigate the existence of this physical phenomena namely silence cone zone (the zone where radiated power is nulled). First, we overview antenna types and properties that have the major impact on the shape of the electromagnetic field. Then we model various off the shelf dipoles in Matlab based on antennas’ features (dimensions, gain, operating frequency, … etc.) and compare the resulting radiation patterns. After that, we validate the existence of the null zone in Omni-directional antennas by conducting experiments and generating waveforms (using USRP1 and USRP2) at various frequencies using different types of antennas and gains in indoor/outdoor. We capture the generated waveforms around antennas' null zone in the reactive, near, and far field with a spectrum analyzer mounted on a drone, using various off the shelf antennas. We analyze the captured signals in RF-Explorer and plot the impact on received power and signal amplitude inside and around the null zone. Finally, it is concluded from evaluation and measurements the existence of null zones in Omni-directional antennas which we plan on extending this work in the near future to investigate the usability of the null zone for various applications such as localization and path finding.

Keywords: antennas, amplitude, field regions, frequency, FSPL, omni-directional, radiation pattern, RSSI, silence zone cone

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Authors: Hoang Vo Thi Minh, Duyen Nguyen Thi Phuong, Gerardo Van Halsema

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As one of the deltas which is extremely vulnerable to climate change, the Mekong Delta, Vietnam is facing many challenges that need to be addressed in strategic and holistic ways. In this study scope, a strategic delta planning is recently considered as a new vision of Adaptive Delta Management for the Mekong Delta. In Adaptive Delta Management, Room for the Rivers (RftR) has been formulated as a typical innovation, which is currently in need of careful consideration for implementing in the Mekong Delta’s planning process. This study then attempts to investigate the roles and analyze sociological aspects of the RftR as potential strategic 'soft' measure, in upstream of Hau River in An Phu district, An Giang province, especially in terms of its so-called multifunctions. The study applied social science approach embedded with a few qualitative methods including in-depth interviews and questionnaire distribution and conjoint analysis as a quantitative approach. The former mainly aims at gaining the local community’s perceptions about the RftR solution. The latter tries to gain farmers’ willingness to accept (WTA) with regard to their level of preference towards the three selected solutions which are considered as strategic plans for sustainably developing the MD. Qualitative data analysis shows that, farmers perceive RftR as very useful for their livelihoods due to its multifunctions as well as in terms of water management. The quantitative results illustrated that respondents expressed their WTAs on RftR as 84. 240 thousand VND / year. Amongst the three solutions that are analysed within this study (Floating rice for upper delta, Room for the Rivers for the Middle, and Shrimp-Mangrove integration for the coastal delta), RfrR was ranked as second preference from respondents. This result is not exactly reflecting the real values of these three mentioned solutions but showing a tendency that can be seen as a reference for the decision-makers in delta planning processes.

Keywords: strategic delta planning, room for the River, farmers’ perception, willingness-to-accept, local livelihoods

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Authors: Thidilweli Denga, Bessie Malila, Lucretia Petersen

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The Coronavirus Disease of 2019 (COVID-19) pandemic should be taken as a wake-up call on the importance of hearing health care considering amongst other things the electronic methods of communication used. The World Health Organization (WHO) estimated that by 2050, there will be more than 2.5 billion people living with hearing loss. These numbers show that more people will need rehabilitation services. Studies have shown that most people living with hearing loss reside in Low-Middle Income Countries (LIMC). Innovative technological solutions such as digital health interventions that can be used to deliver hearing health services to remote areas now exist. Tele-audiology implementation can potentially enable the delivery of hearing loss services to rural and remote areas. This study aimed to establish the concurrent validity of the tele-audiology practice in school-based hearing screening. The study employed a cross-sectional design with a within-group comparison. The portable KUDUwave Audiometer was used to conduct hearing screening from 50 participants (n=50). In phase I of the study, the audiologist conducted on-site hearing screening, while the synchronous remote hearing screening (tele-audiology) using a 5G network was done in phase II. On-site hearing screening results were obtained for the first 25 participants (aged between 5-6 years). The second half started with the synchronous tele-audiology model to avoid order-effect. Repeated sample t-tests compared threshold results obtained in the left and right ears for onsite and remote screening. There was a good correspondence between the two methods with a threshold average within ±5 dB (decibels). The synchronous tele-audiology model has the potential to reduce the audiologists' case overload, while at the same time reaching populations that lack access due to distance, and shortage of hearing professionals in their areas of reach. With reliable and broadband connectivity, tele-audiology delivers the same service quality as the conventional method while reducing the travel costs of audiologists.

Keywords: hearing screening, low-resource communities, portable audiometer, tele-audiology

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Authors: Dyah Larasati, Karishma Alize Huda, Sri Kusumastuti Rahayu, Martin Daniel Siyaranamual

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Indonesia continues to reform its social protection system to provide the needed protection for its citizen. Indonesia Social Protection consisted of social assistance programs (non-contributory/tax-financed) specifically targeted for the poor and at-risk and social security/insurance program (contributory system). The social assistance programs have mostly been implemented since 1998. The national health insurance has been implemented since 2014 and the employment social insurance since 2015. One major reform implemented has been improving the targeting performance of its major social assistance portfolios including (1) Food Assistance for the poor families (Rastra and BPNT/noncash foods assistance); (2) Education Assistance for poor children; (3) Conditional Cash Transfer for poor families (PKH); and (4) Subsidized beneficiaries of National Health Insurance (JKN-PBI) for the poor and at-risk individuals. For the Social Insurance (through BPJS Employment program), several initiatives have been implemented to expand the program contributing members, although it mostly benefits the formal sector workers. However, major gaps still exist especially for the emerging middle-income groups who typically work at the informal sectors. They have yet to get the protection needed to sustain their social and economic growth. Since 2017, TNP2K (the National Team for Poverty Reduction) under the Vice President office has led the social protection discourse as the government understands the need to address vulnerabilities across the lifecycle and prioritize support to the most at-risk population particularly the elderly, young children and people with disabilities. Discussion and advocacy to recommend for more investment is continuing in order for the government to establish a comprehensive social protection system in the near future (2020-2024) that protects children through an inclusive child benefit program; build a system to benefit more working-age adults (including individuals with disabilities) and a three-tier elderly protection as they reach 65 years.

Keywords: poverty reduction, social assistance, social insurance, social protection

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Authors: Keneilwe Matlhaku

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Crosslinguistic studies (theoretical and clinical) have shown delays and significant misarticulation in the acquisition of the rhotics. This article provides a detailed analysis of the early development of the rhotic phoneme, an apical trill /r/, by monolingual Setswana (Tswana S30) children of age ranges between 1 and 4 years. The data display the following trends: (1) late acquisition of /r/; (2) a wide range of substitution patterns involving this phoneme (i.e., gliding, coronal stopping, affrication, deletion, lateralization, as well as, substitution to a dental and uvular fricative). The primary focus of the article is on the potential origins of these variations of /r/, even within the same language. Our data comprises naturalistic longitudinal audio recordings of 6 children (2 males and 4 females) whose speech was recorded in their homes over a period of 4 months with no or only minimal disruptions in their daily environments. Phon software (Rose et al. 2013; Rose & MacWhinney 2014) was used to carry out the orthographic and phonetic transcriptions of the children’s data. Phon also enabled the generation of the children’s phonological inventories for comparison with adult target IPA forms. We explain the children’s patterns through current models of phonological emergence (MacWhinney 2015) as well as McAllister Byun, Inkelas & Rose (2016); Rose et al., (2022), which highlight the perceptual and articulatory factors influencing the development of sounds and sound classes. We highlight how the substitution patterns observed in the data can be captured through a consideration of the auditory properties of the target speech sounds, combined with an understanding of the types of articulatory gestures involved in the production of these sounds. These considerations, in turn, highlight some of the most central aspects of the challenges faced by the child toward learning these auditory-articulatory mappings. We provide a cross-linguistic survey of the acquisition of rhotic consonants in a sample of related and unrelated languages in which we show that the variability and volatility in the substitution patterns of /r/ is also brought about by the properties of the children’s ambient languages. Beyond theoretical issues, this article sets an initial foundation for developing speech-language pathology materials and services for Setswana learning children, an emerging area of public service in Botswana.

Keywords: rhotic, apical trill, Phon, phonological emergence, auditory, articulatory, mapping

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Authors: Paul Lam, Chi Him Chan, Alan Tse

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Language laboratories have been widely used in language learning, starting in the middle of the last century as one of the earliest forms of educational technology. They are designed to assist students’ language learning with technological innovations. Traditional language laboratories provide individual workstations that allow students to access multimedia language resources. In this type of facility, students can train their listening and speaking abilities, and teachers can also assess the performance of an individual student. Although such a setting promotes a student-centered pedagogy by encouraging students to work at their own pace and according to their own needs, it still favours a traditional, behaviourist language learning pedagogy which focuses on repetitive drilling. The change of pedagogies poses challenges to both the teachers and the facilities. The peer-learning pedagogy advocates that language learning should focus on the social aspect, which emphasizes the importance of everyday communication in language learning. The self-access, individual workstation language laboratories may not be able to provide the flexibility for interaction in the new pedagogies. Modern advancement in technology is another factor that drove our language laboratory renovation. In particular, mobile and wireless technology enabled the use of smaller and more flexible devices, making possible much clever use of space. The Chinese University of Hong Kong (CUHK) renovated nine existing language laboratories to provide lighter and more advanced equipment, movable tables, and round desks. These facilities allow more flexibility and encourage students’ interaction. It is believed that the renovated language laboratories can serve different peer learning activities and thus support peer-learning pedagogies in language teaching and learning. A survey has been conducted to collect comments from the teachers who have used the renovated language laboratories and received forty-four response. The teachers’ comments reveal that they experienced different challenges in using the renovated language laboratories, and there is a need to provide guidance to teachers during the technological and pedagogical transition. For example, teachers need instruction on using the newly installed devices such as touch-monitor and visualizer. They also need advice on planning new teaching and learning activities. Nevertheless, teachers appreciated that the renovated language laboratories are flexible and provide more spaces for different learning activities.

Keywords: language laboratories, language learning, peer-learning, student interaction

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Authors: Zarini Ismail, Nurul Azmawati Mohamed, Shalinawati Ramli, Nurul Hayati Chamhuri, Nur Syahrina Rahim, Khairani Omar

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Choosing a career is one of the most important decisions that people have to make in life. While choosing a suitable career, a person cannot ignore their intrinsic traits such as the type of personality, interests, values, and aptitude. The objective of this study is to ascertain the personality of the pre-clinical medical students and their reasons or intentions for choosing medicine as a career. This study is a cross-sectional study involving Year 3 pre-clinical medical students at Universiti Sains Islam Malaysia. Participants were given a set of validated questionnaires on demographic data and open-ended questions for reasons of choosing medicine. Thematic analysis were used to analyse the open-ended question. The Participants were also required to answer a Career Interest Questionnaire (based on Holland’s Theory). A total of 81 Year 3 medical students were involved in this study. About two third (69%) of them were female and their age ranged from 20 to 21 years old. The majority of them were from middle-income families. From the thematic analysis, there were several reasons given for choosing medicine by the students. The majority of the students stated that it was their passion and interest in the medical field (45.7%). Approximately 24.7% decided to take the medical course because of parents/family influenced and 19.8% mentioned that they wanted to help the society. Other themes emerged were jobs opportunity in future (1.2%) and influenced by friends (3.7%). Based on Holland’s theory, ideally to become a good medical doctor one should score high in investigative and social personality trait. However, 26.3% of the students had low scores in these personality traits. We then looked into the reasons given by these students for choosing medicine. Approximately 28% were due to parents/family decision while 52% admitted that it was due to their interest. When compared with the group of students with high personality scores (investigative and social), there was not much difference in the reasons given for choosing medicine. The main reasons given by the students for choosing medicine were own interest, family’s influence and to help others. However, a proportion of them had low scores in the personality traits which are relevant for medicine. Although some of these students admitted that they choose medicine based on their interest, their strength might not be suitable for their chosen carrier.

Keywords: career, medical students, medicine, personality

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Authors: Komal Khan, Hafsa Zaneb, Saima Masood, Muhammad Younus, Sanan Raza

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Cigarette smoke induces many physiological and pathological changes in respiratory tract like goblet cell hyperplasia and regional distention of airspaces. It is also associated with elevation of inflammatory profiles in different airway compartments. As probiotics are generally known to promote mucosal tolerance, it was postulated that prophylactic use of probiotics can be helpful in reduction of respiratory damage induced by cigarette smoke exposure. Twenty-four adult mice were randomly divided into three groups (cigarette-smoke (CS) group, cigarette-smoke+ Lactobacillus (CS+ P) group, control (Cn) group), each having 8 mice. They were exposed to cigarette smoke for 28 days (6 cigarettes/ day for 6 days/week). Wright-Giemsa staining of bronchoalveolar lavage fluid (BALF) was performed in three mice per group. Tissue samples of trachea and lungs of 7 mice from each group were processed by paraffin embedding technique for haematoxylin & eosin (H & E) and alcian blue- periodic acid-Schiff (AB-PAS) staining. Then trachea (goblet cell number, ratio and loss of cilia) and lungs (airspace distention) were studied. The results showed that the number of goblet cells was increased in CS group as a result of defensive mechanism of the respiratory system against irritating substances. This study also revealed that the cells of CS group having acidic glycoprotein were found to be higher in quantity as compared to those containing neutral glycoprotein. However, CS + P group showed a decrease in goblet cell index due to enhanced immunity by prophylactically used probiotics. Moreover, H & E stained tracheas showed significant loss of cilia in CS group due to propelling of mucous but little loss in CS + P group because of having good protective tracheal epithelium. In lungs, protection of airspaces was also much more evident in CS+ P group as compared to CS group having distended airspaces, especially at 150um distance from terminal bronchiole. In addition, a comprehensive analysis of inflammatory cells population of BALF showed neutrophilia and eosinophilia was significantly reduced in CS+ P group. This study proved that probiotics are found to be useful for reduction of changes in micro-architecture of the respiratory system. Thus, dietary supplementation of probiotic as prophylactic measure can be useful in achieving immunomodulatory effects.

Keywords: cigarette smoke, probiotics, goblet cells, airspace enlargement, BALF

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Authors: Lubna Azmi, Ila Shukla, Shyam Sundar Gupta, Padam Kant, C. V. Rao

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To investigate the chemoprotective potential of NBRIQU16 chemotype isolated from Argyreia speciosa (Family: Convolvulaceae) on N-methyl-N-nitro-N-nitrosoguanidine (MNNG) and NaCl-induced gastric carcinomas in Wistar rats. Forty-six male 6-week-old Wistar rats were divided into two groups. Thirty rats in group A were fed with a diet supplemented with 8 % NaCl for 20 weeks and simultaneously given N-methyl-N’-nitro-N-nitrosoguanidine (MNNG) in drinking water at a concentration of 100 ug/ml for the first 17 weeks. After administration of the carcinogen, 200 and 400 mg/kg of NBRIQU16 were administered orally once a day throughout the study. From week 18, these rats were given normal water. From week 21, these rats were fed with a normal diet for 15 weeks. Group B containing 16 rats was fed standard diet for thirty-five days. It served as control. Ten rats from group A were sacrificed after 20 weeks. Scarification of remaining animals was conducted after 35 weeks. Entire stomach and some part of the duodenum were incised parallel to the greater curvature, and the samples were collected. After opening the stomach location and size of tumors were recorded. The number of tumors with their locations and sizes were recorded. Expression of survivin was examined by recording the Immunohistochemistry of the specimens. The treatment with NBRIQU16 significantly reduced the nodule incidence and nodule multiplicity in the rats after MNNG administration. Surviving expression in glandular stomachs of normal rats, of rats in middle induction period, in adenocarcinomas and NBRIQU16 treated tissues adjacent to tumor were 0, 42.0 %, 79.3%, and 36.4 %, respectively. Expression of survivin was significantly different as compared to the normal rats. Histological observations of stomach tissues too correlated with the biochemical observations.These finding powerfully supports that NBRIQU16 chemopreventive effect by suppressing the tumor burden and restoring the activities of gastric cancer marker enzymes on MNNG and NaCl-induced gastric carcinomas in Wistar rats.

Keywords: Argyreia speciosa, gastric carcinoma, immunochemistry, NBRIQU16

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Authors: Krasimira N. Zhilkova, Mariya K. Kyulavska, Roza P. Mateva

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The anionic polymerization of -caprolactam (CL) with bifunctional activators has been extensively studied as an effective and beneficial method of improving chemical and impact resistances, elasticity and other mechanical properties of polyamide (PA6). In presence of activators or macroactivators (MAs) also called polymeric activators (PACs) the anionic polymerization of lactams proceeds rapidly at a temperature range of 130-180C, well below the melting point of PA-6 (220C) permitting thus the direct manufacturing of copolymer product together with desired modifications of polyamide properties. Copolymers of PA6 with an elastic polypropylene glycol (PPG) middle block into main chain were successfully synthesized via activated anionic ring opening polymerization (ROP) of CL. Using novel PACs based on PPG polyols (with differ molecular weight) the anionic ROP of CL was realized and investigated in the presence of a basic initiator sodium salt of CL (NaCL). The PACs were synthesized as N-carbamoyllactam derivatives of hydroxyl terminated PPG functionalized with isophorone diisocyanate [IPh, 5-Isocyanato-1-(isocyanatomethyl)-1,3,3-trimethylcyclohexane] and blocked then with CL units via an addition reaction. The block copolymers were analyzed and proved with 1H-NMR and FT-IR spectroscopy. The influence of the CL/PACs ratio in feed, the length of the PPG segments and polymerization conditions on the kinetics of anionic ROP, on average molecular weight, and on the structure of the obtained block copolymers were investigated. The structure and phase behaviour of the copolymers were explored with differential scanning calorimetry, wide-angle X-ray diffraction, thermogravimetric analysis and dynamic mechanical thermal analysis. The crystallinity dependence of PPG content incorporated into copolymers main backbone was estimate. Additionally, the mechanical properties of the obtained copolymers were studied by notched impact test. From the performed investigation in this study could be concluded that using PPG based PACs at the chosen ROP conditions leads to obtaining well-defined PA6-b-PPG-b-PA6 copolymers with improved impact resistance.

Keywords: anionic ring opening polymerization, caprolactam, polyamide copolymers, polypropylene glycol

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Authors: Katherine Karayianis

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Children with Attention Deficit Hyperactivity Disorder (ADHD) have trouble learning in traditional classrooms. These children miss out on important developmental opportunities in school, which leads to challenges starting in early childhood, and these problems persist throughout their adult lives. Despite receiving supplemental support in school, children with ADHD still perform below their non-ADHD peers. Thus, there is a great need to find better ways of facilitating learning in children with ADHD. Evidence has shown that children with ADHD learn best through interactive engagement, but this is not always possible in schools, given classroom restraints and the large student-to-teacher ratio. Redesigning classrooms may not be feasible, so informal learning opportunities provide a possible alternative. One popular informal learning opportunity is educational TV shows like Sesame Street. These types of educational shows can teach children foundational skills taught in pre-K and early elementary school. One downside to these shows is the lack of interactive dialogue between the TV characters and the child viewers. Pseudo-interaction is often deployed, but the benefits are limited if the characters can neither understand nor contingently respond to the child. AI technology has become extremely advanced and is now popular in many electronic devices that both children and adults have access to. AI has been successfully used to create interactive dialogue in children’s educational TV shows, and results show that this enhances children’s learning and engagement, especially when children perceive the character as a reliable teacher. It is likely that children with ADHD, whose minds may otherwise wander, may especially benefit from this type of interactive technology, possibly to a greater extent depending on their perception of the animated dialogic agent. To investigate this issue, I have begun examining the moderating role of inattention among children’s learning from an educational TV show with different types of dialogic interactions. Preliminary results have shown that when character interactions are neither immediate nor accurate, children who are more easily distracted will have greater difficulty learning from the show, but contingent interactions with a TV character seem to buffer these negative effects of distractibility by keeping the child engaged. To extend this line of work, the moderating role of the child’s perception of the dialogic agent as a reliable teacher will be examined in the association between children’s attention and the type of dialogic interaction in the TV show. As such, the current study will investigate this moderated moderation.

Keywords: attention, dialogic TV, informal learning, educational TV, perception of teacher

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Authors: Ugo Rovigatti

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Neuroblastoma (NBL) has epitomized for at least 40 years our understanding of cancer cellular and molecular biology and its potential applications to novel therapeutic strategies. This includes the discovery of the very first oncogene aberrations and tumorigenesis suppression by differentiation in the 80s; the potential role of suppressor genes in the 90s; the relevance of immunotherapy in the millennium first, and the discovery of additional mutations by NGS technology in the millennium second decade. Similar discoveries were achieved in the majority of human cancers, and similar therapeutic interventions were obtained subsequently to NBL discoveries. Unfortunately, targeted therapies suggested by specific mutations (such as MYCN amplification –MNA- present in ¼ or 1/5 of cases) have not elicited therapeutic successes in aggressive NBL, where the prognosis is still dismal. The reasons appear to be linked to Tumor Heterogeneity, which is particularly evident in NBL but also a clear hallmark of aggressive human cancers generally. The new avenue of cancer immunotherapy (CIT) provided new hopes for cancer patients, but we still ignore the cellular or molecular targets. CIT is emblematic of high-risk disease (HR-NBL) since the mentioned GD2 passive immunotherapy is still providing better survival. We recently critically reviewed and evaluated the literature depicting the genomic landscapes of HR-NBL, coming to the qualified conclusion that among hundreds of affected genes, potential targets, or chromosomal sites, none correlated with anti-GD2 sensitivity. A better explanation is provided by the Micro-Foci inducing Virus (MFV) model, which predicts that neuroblasts infection with the MFV, an RNA virus isolated from a cancer-cluster (space-time association) of HR-NBL cases, elicits the appearance of MNA and additional genomic aberrations with mechanisms resembling chromothripsis. Neuroblasts infected with low titers of MFV amplified MYCN up to 100 folds and became highly transformed and malignant, thus causing neuroblastoma in young rat pups of strains SD and Fisher-344 and larger tumor masses in nu/nu mice. An association was discovered with GD2 since this glycosphingolipid is also the receptor for the family of MFV virus (dsRNA viruses). It is concluded that a dsRNA virus, MFV, appears to provide better explicatory mechanisms for the genesis of i) specific genomic aberrations such as MNA; ii) extensive tumor heterogeneity and chromothripsis; iii) the effects of passive immunotherapy with anti-GD2 monoclonals and that this and similar models should be further investigated in both pediatric and adult cancers.

Keywords: neuroblastoma, MYCN, amplification, viruses, GD2

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