Search results for: data reproducibility

Authors: Bahar Hazal Yalçınkaya, Bayram Yılmaz, Mustafa Özilgen

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Brain information transmission in the neuronal network occurs in the form of electrical signals. Neural work transmits information between the neurons or neurons and target cells by moving charged particles in a voltage field; a fraction of the energy utilized in this process is dissipated via entropy generation. Exergy loss and entropy generation models demonstrate the inefficiencies of the communication along the dendritic trees. In this study, neurons of 4 different animals were analyzed with one dimensional cable model with N=6 identical dendritic trees and M=3 order of symmetrical branching. Each branch symmetrically bifurcates in accordance with the 3/2 power law in an infinitely long cylinder with the usual core conductor assumptions, where membrane potential is conserved in the core conductor at all branching points. In the model, exergy loss and entropy generation rates are calculated for each branch of equivalent cylinders of electrotonic length (L) ranging from 0.1 to 1.5 for four different dendritic branches, input branch (BI), and sister branch (BS) and two cousin branches (BC-1 & BC-2). Thermodynamic analysis with the data coming from two different cat motoneuron studies show that in both experiments nearly the same amount of exergy is lost while generating nearly the same amount of entropy. Guinea pig vagal motoneuron loses twofold more exergy compared to the cat models and the squid exergy loss and entropy generation were nearly tenfold compared to the guinea pig vagal motoneuron model. Thermodynamic analysis show that the dissipated energy in the dendritic tress is directly proportional with the electrotonic length, exergy loss and entropy generation. Entropy generation and exergy loss show variability not only between the vertebrate and invertebrates but also within the same class. Concurrently, single action potential Na⁺ ion load, metabolic energy utilization and its thermodynamic aspect contributed for squid giant axon and mammalian motoneuron model. Energy demand is supplied to the neurons in the form of Adenosine triphosphate (ATP). Exergy destruction and entropy generation upon ATP hydrolysis are calculated. ATP utilization, exergy destruction and entropy generation showed differences in each model depending on the variations in the ion transport along the channels.

Keywords: ATP utilization, entropy generation, exergy loss, neuronal information transmittance

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Authors: Dalia El Hadi, Alaa Bou Ghannam, Hala Mostafa, Hana Mansour, Ibrahim Hashim, Soubhi Tahhan, Tharwat El Zahran

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Introduction: Neuro-ophthalmological emergencies require prompt assessment and management to avoid vision or life-threatening sequelae. Some would require neuroimaging. Most commonly used are the CT and MRI of the Brain. They can be over-used when not indicated. Their yield remains dependent on multiple factors relating to the clinical scenario. Methods: A retrospective cross-sectional study was conducted by reviewing the electronic medical records of patients presenting to the Emergency Department (ED) with isolated neuro-ophthalmologic complaints. For each patient, data were collected on the clinical presentation, whether neuroimaging was performed (and which type), and the result of neuroimaging. Analysis of the performed neuroimaging was made, and its yield was determined. Results: A total of 211 patients were reviewed. The complaints or symptoms at presentation were: blurry vision, change in the visual field, transient vision loss, floaters, double vision, eye pain, eyelid droop, headache, dizziness and others such as nausea or vomiting. In the ED, a total of 126 neuroimaging procedures were performed. Ninety-four imagings (74.6%) were normal, while 32 (25.4%) had relevant abnormal findings. Only 2 symptoms were significant for abnormal imaging: blurry vision (p-value= 0.038) and visual field change (p-value= 0.014). While 4 physical exam findings had significant abnormal imaging: visual field defect (p-value= 0.016), abnormal pupil reactivity (p-value= 0.028), afferent pupillary defect (p-value= 0.018), and abnormal optic disc exam (p-value= 0.009). Conclusion: Risk indicators for abnormal neuroimaging in the setting of neuro-ophthalmological emergencies are blurred vision or changes in the visual field on history taking. While visual field irregularities, abnormal pupil reactivity with or without afferent pupillary defect, or abnormal optic discs, are risk factors related to physical testing. These findings, when present, should sway the ED physician towards neuroimaging but still individualizing each case is of utmost importance to prevent time-consuming, resource-draining, and sometimes unnecessary workup. In the end, it suggests a well-structured patient-centered algorithm to be followed by ED physicians.

Keywords: emergency department, neuro-ophthalmology, neuroimaging, risk indicators

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Authors: Kemkanit Sanyanunthana

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The purpose of this research is to study the management system of information technology which supports the education of five private universities in Thailand, according to the case studies which have been developing their qualities and standards of management and education by service provision of information technology to support the excellence performance. The concept to connect information technology with a suitable system has been created by information technology administrators for development, as a system that can be used throughout the organizations to help reach the utmost benefits of using all resources. Hence, the researcher as a person who has been performing these duties within higher education is interested to do this research by selecting the Control Objective for Information and Related Technology 5 (COBIT 5) for the Malcolm Baldrige National Quality Award (MBNQA) of America, or the National Award which applies the concept of Total Quality Management (TQM) to the organization evaluation. Such evaluation is called the Education Criteria for Performance Excellence (EdPEx) focuses on studying and comparing education quality development for excellent performance using COBIT 5 in terms of information technology to study the problems and obstacles of the investigation process for an information technology system, which is considered as an instrument to drive all organizations to reach the excellence performance of the information technology, and to be the model of evaluation and analysis of the process to be in accordance with the strategic plans of the information technology in the universities. This research is conducted in the form of descriptive and survey research according to the case studies. The data collection were carried out by using questionnaires through the administrators working related to the information technology field, and the research documents related to the change management as the main study. The research can be concluded that the performance based on the APO domain process (ALIGN, PLAN AND ORGANISE) of the COBIT 5 standard frame, which emphasizes concordant governance and management of strategic plans for the organizations, could reach only 95%. This might be because of some restrictions such as organizational cultures; therefore, the researcher has studied and analyzed the management of information technology in universities as a whole, under the organizational structures, to reach the performance in accordance with the overall APO domain which would affect the determined strategic plans to be able to develop based on the excellence performance of information technology, and to apply the risk management system at the organizational level into every performance process which would develop the work effectiveness for the resources management of information technology to reach the utmost benefits. 

Keywords: COBIT5, APO, EdPEx Criteria, MBNQA

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Authors: Anila Naz, Arusa Lakhani, Kiran Mubeen, Yasmeen Amarsi

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Pakistan's neonatal mortality rate has the highest proportion in the South Asian region and it is higher in the rural areas as compared to the urban areas. Poor resuscitation techniques and lack of basic newborn resuscitation skills in birth attendants, are contributing factors towards neonatal deaths. Based on the significant outcomes of the Helping Baby Breath (HBB) training, a similar training was implemented for Community Midwives (CMWs) in a low resource setting in Gujrat, Pakistan, to improve their knowledge and skills. The training evaluation was conducted and participant feedback was obtained through both qualitative and quantitative methods. The findings of the quantitative assessment of the training evaluation will be published elsewhere. This paper presents the qualitative evaluation of the training. Objective: The objective of the study was to determine the perceptions of HBB trained CMWs about the effectiveness of the HBB training, and the challenges faced in the implementation of HBB skills for newborn resuscitation, at their work settings. The qualitative descriptive design was used in this study. The purposive sampling technique was chosen to recruit midwives and key informants as participants of the training. Interviews were conducted by using a semi-structured interview guide. The study included a total of five interviews: two focus group interviews for CMWs (10 in each group), and three individual interviews of key informants. The content analysis of the qualitative data yielded three themes: the effectiveness of training, challenges, and suggestions. The findings revealed that the HBB training was effective for the CMWs in terms of its usability, regarding improvement in newborn resuscitation knowledge and skills. Moreover, it enhanced confidence and satisfaction in CMWs. However, less volume of patients was a challenge for a few CMWs with regards to practicing their skills. Due to the inadequate number of patients and less opportunities of practice for several CMWs, they required such trainings frequently, in order to maintain their competency. The CMWs also recommended that HBB training should be part of the Midwifery program curriculum. Moreover, similar trainings were also recommended for other healthcare providers working in low resource settings, including doctors and nurses.

Keywords: neonatal resuscitation technique, helping baby breathe, community midwives, training evaluation

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Authors: Saidur R. Chowdhury, Mamme K. Addai, Ernest K. Yanful

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The research was performed to assess the potential of nickel smelter slag, an industrial waste, as an adsorbent in the removal of metals from aqueous solution. An investigation was carried out for Arsenic (As), Copper (Cu), lead (Pb) and Cadmium (Cd) adsorption from aqueous solution. Smelter slag was obtain from Ni ore at the Vale Inco Ni smelter in Sudbury, Ontario, Canada. The batch experimental studies were conducted to evaluate the removal efficiencies of smelter slag. The slag was characterized by surface analytical techniques. The slag contained different iron oxides and iron silicate bearing compounds. In this study, the effect of pH, contact time, particle size, competition by other ions, slag dose and distribution coefficient were evaluated to measure the optimum adsorption conditions of the slag as an adsorbent for As, Cu, Pb and Cd. The results showed 95-99% removal of As, Cu, Pb, and almost 50-60% removal of Cd, while batch experimental studies were conducted at 5-10 mg/L of initial concentration of metals, 10 g/L of slag doses, 10 hours of contact time and 170 rpm of shaking speed and 25oC condition. The maximum removal of Arsenic (As), Copper (Cu), lead (Pb) was achieved at pH 5 while the maximum removal of Cd was found after pH 7. The column experiment was also conducted to evaluate adsorption depth and service time for metal removal. This study also determined adsorption capacity, adsorption rate and mass transfer rate. The maximum adsorption capacity was found to be 3.84 mg/g for As, 4 mg/g for Pb, and 3.86 mg/g for Cu. The adsorption capacity of nickel slag for the four test metals were in decreasing order of Pb > Cu > As > Cd. Modelling of experimental data with Visual MINTEQ revealed that saturation indices of < 0 were recorded in all cases suggesting that the metals at this pH were under- saturated and thus in their aqueous forms. This confirms the absence of precipitation in the removal of these metals at the pHs. The experimental results also showed that Fe and Ni leaching from the slag during the adsorption process was found to be very minimal, ranging from 0.01 to 0.022 mg/L indicating the potential adsorbent in the treatment industry. The study also revealed that waste product (Ni smelter slag) can be used about five times more before disposal in a landfill or as a stabilization material. It also highlighted the recycled slags as a potential reactive adsorbent in the field of remediation engineering. It also explored the benefits of using renewable waste products for the water treatment industry.

Keywords: adsorption, industrial waste, recycling, slag, treatment

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Authors: Tharwat Ibrahim Rushdy, Warda Youssef Mohammed Morsy, Hanaa Ali Ahmed Elfeky

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Background: Intra-aortic balloon pump (IABP) is the first and the most commonly used mechanical circulatory support for patients with acute coronary syndromes and cardiogenic shock. Therefore, critical care nurses not only have to know how to monitor and operate the IABP, but also to provide interventions for preventing possible complications. Aim of the study: To assess nurses' knowledge and practices regarding care of patients connected to IABP at the ICUs of Cairo University Hospitals. Research design: A descriptive exploratory design was utilized. Sample: Convenience samples of 40 nurses were included in the current study. Setting: This study was carried out at the Intensive Care Units of Cairo University Hospitals. Tools of data collection: Three tools were developed, tested for clarity, and feasibility: a- Nurses' personal background sheet, b- IABP nurses' knowledge self-administered questionnaire, and c- IABP Nurses' practice observational checklist. Results: The majority of the studied sample had unsatisfactory knowledge and practice level (88% & 95%) respectively with a mean of 9.45+2.94 and 30.5+8.7, respectively. Unsatisfactory knowledge was found regarding description and physiological effects, nursing care, indications, contraindications, complications, weaning, and removal of IABP in percentage of 95%, 90%, 72.5%, and 57.5%, respectively, with a mean total knowledge score of 9.45 +2.94. In addition, unsatisfactory practice was found regarding about preparation and initiation of IABP therapy, nursing practice during therapy, weaning, and removal of IABP in percentages of (97.5%, 97.5%, and 90%), respectively. Finally, knowledge level was found to differ significantly in relation to gender (t = 2.46 at P ≤ 0.018). However, gender didn't play a role in relation to practice (t = 0.086 at P≤ 0.932). Conclusion: In spite of having vital role in assessment and management of critically ill patients, critical care nurses in the current study had in general unsatisfactory knowledge and practice regarding care of patients connected to IABP. Recommendation: updating knowledge and practice of ICU nurses through carrying out continuing educational programs about IABP; strict observation of nurses' practice when caring for patients connected to IABP and provision of guidance to correct of poor practices and replication of this study on larger probability sample selected from different geographical locations.

Keywords: knowledge, practice, intra-aortic balloon pump (IABP), ICU nurses, intensive care unit (ICU), introduction

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Authors: Disha Bhanot, Vinish Kathuria

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This study focusses on the issue of distress sale in horticulture sector in India, which faces unique challenges, given the perishable nature of horticulture crops, seasonal production and paucity of post-harvest produce management links. Distress sale, from a farmer’s perspective may be defined as urgent sale of normal or distressed goods, at deeply discounted prices (way below the cost of production) and it is usually characterized by unfavorable conditions for the seller (farmer). The small and marginal farmers, often involved in subsistence farming, stand to lose substantially if they receive lower prices than expected prices (typically framed in relation to cost of production). Distress sale maximizes price uncertainty of produce leading to substantial income loss; and with increase in input costs of farming, the high variability in harvest price severely affects profit margin of farmers, thereby affecting their survival. The objective of this study is to model the occurrence of distress sale by tomato cultivators in the Indian state of Maharashtra, against the background of differential access to set of factors such as - capital, irrigation facilities, warehousing, storage and processing facilities, and institutional arrangements for procurement etc. Data is being collected using primary survey of over 200 farmers in key tomato growing areas of Maharashtra, asking information on the above factors in addition to seeking information on cost of cultivation, selling price, time gap between harvesting and selling, role of middleman in selling, besides other socio-economic variables. Farmers selling their produce far below the cost of production would indicate an occurrence of distress sale. Occurrence of distress sale would then be modelled as a function of farm, household and institutional characteristics. Heckman-two-stage model would be applied to find the probability/likelihood of a famer falling into distress sale as well as to ascertain how the extent of distress sale varies in presence/absence of various factors. Findings of the study would recommend suitable interventions and promotion of strategies that would help farmers better manage price uncertainties, avoid distress sale and increase profit margins, having direct implications on poverty.

Keywords: distress sale, horticulture, income loss, India, price uncertainity

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Authors: Daniela E. Marin, Cornelia Braicu, Gina C. Pistol, Roxana Cojocneanu-Petric, Ioana Berindan Neagoe, Mihail A. Gras, Ionelia Taranu

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Aristolochic acid (AA) is a carcinogenic, mutagenic, and nephrotoxic compound commonly found in the Aristolochiaceae family of plants. AA is frequently associated with urothelial carcinoma of the upper urinary tract in human and animals and is considered as being responsible for Balkan Endemic Nephropathy. The pig provides a good animal model because the porcine urological system is very similar to that of humans, both in aspects of physiology and anatomy. MicroRNA (miRNA) are small non-coding RNAs that have an impact on a wide range of biological processes by regulating gene expression at post-transcriptional level. The objective of this study was to analyze the miRNA profiling in the kidneys of AA intoxicated swine. For this purpose, ten TOPIGS-40 crossbred weaned piglets, 4-week-old, male and females with an initial average body weight of 9.83 ± 0.5 kg were studied for 28 days. They were given ad libitum access to water and feed and randomly allotted to one of the following groups: control group (C) or aristolochic acid group (AA). They were fed a maize-soybean-meal-based diet contaminated or not with 0.25mgAA/kg. To profile miRNA in the kidneys of pigs, microarrays and bioinformatics approaches were applied to analyze the miRNA in the kidney of control and AA intoxicated pigs. After normalization, our results have shown that a total of 5 known miRNAs and 4 novel miRNAs had different profiling in the kidney of intoxicated animals versus control ones. Expression of miR-32-5p, miR-497-5p, miR-423-3p, miR-218-5p, miR-128-3p were up-regulated by 0.25mgAA/kg feed, while the expression of miR-9793-5p, miR-9835-3p, miR-9840-3p, miR-4334-5p was down-regulated. The microRNA profiling in kidney of intoxicated animals was associated with modified expression of target genes as: RICTOR, LASP1, SFRP2, DKK2, BMI1, RAF1, IGF1R, MAP2K1, WEE1, HDGF, BCL2, EIF4E etc, involved in cell division cycle, apoptosis, cell differentiation and cell migration, cell signaling, cancer etc. In conclusion, this study provides new data concerning the microRNA profiling in kidney after aristolochic acid intoxications with important implications for human and animal health.

Keywords: aristolochic acid, kidney, microRNA, swine

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Authors: Faizan Sultan

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Non-government organizations (NGOs) in Pakistan have the potential to deliver services such as health, education, and rural development through targeting the most vulnerable communities of society. Having this significant importance, NGOs are facing numerous challenges in service delivery. So, there is a need to identify the challenges NGOs face in community development, particularly post-conflict development. The current study has analyzed the social and political constraints in development projects in the post-conflict region of the Swat district of Khyber Pakhtunkhwa. The objectives of this study are “What are the social and political constraints faced by the nongovernmental organizations in the implementation of development aid Projects in post-conflict development of Swat and to examine the challenges in coordination mechanism between government departments, NGOs, and community in reconstruction activities”. This research is based upon both the quantitative and qualitative data that is being gathered from the NGO representatives, government officials, and community members who were involved in post-conflict development interventions in the Swat region. A purposive sampling technique was used to select respondents from the community members/activists (25 in number) and government and NGO officials (10 in number). Based on analysis against our objectives, NGOs have faced numerous constraints such as Insecurity, Negative Perceptions about NGOs, restrictions on women's mobility, government policies and regulations, lack of coordination and networking, trust deficit, and political interference while implementing their project interventions. These findings concluded that constraints have affected project implementation to a greater extent, including women's participation, involvement of marginalized populations, and equal distribution of resources. In the Swat region, NGOs cannot openly discuss sensitive projects such as human rights, gender-based projects, or women empowerment as these issues are very sensitive to the local community due to their cultural values. The community may not allow their females to go outside their homes as this region is a male-dominated society. Similarly, lack of communication and poor networking for the arrangements of the project meetings were also the major constraints.

Keywords: national disaster management authority, millennium development goals, provincial disaster management authority, provincial reconstruction, rehabilitation and settlement authority

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Authors: Tan Xin Zhong Timothy, Chang Chen Jie Victor, Yew Kwan Tong, Lim Geok Peng Sandy

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Background: Leaders in crisis response teams such as Trauma Teams in hospitals are essential to the effective coordination and direction of the team. The response to emergency trauma situations must be accurate, rapid, and well executed. To this end, the team leader’s social, technical and leadership skills are essential factors that implicate the success of an emergency trauma intervention. While each emergency trauma case varies in severity and complexity, and the experience and expertise of team leaders may vary, it would be productive to identify certain coordinative and directive functions that improve the capacity for leading a team. Methods: This qualitative study of Trauma Team physicians in Singapore General Hospital (SGH) involved 50 in-depth interviews with doctors and nurses involved in Trauma Team activations, observations of Trauma Teams managing emergency patients, and reviews of audio/video recordings of 65 trauma activations. The interviews were conducted with doctors of various ranks across the relevant departments, 12 from the Emergency Department (ED), 11 from General Surgery (GS) and 8 from Orthopaedics, while the 6 nurses were from ED. In accordance with the grounded theory approach, the content of the interviews was coded and analysed in order to derive broad leadership themes that corresponded with certain behavioural traits exhibited by trauma team leaders, supplemented with the observational and audio/video data. Results: The leadership behaviours of the team leaders could be typified into three broad categories: team orientation, engagement and activeness. Team orientation corresponds with the source and form of cognitive responsibility, decision-making and informational contributions, divisible into individualistic and consultative sub-categories. Engagement refers to the type of activity that leaders prefer to engage in, and which implicates their attentional focus, divisible into participatory and supervisory sub-categories. Activeness is a function of the leader’s attitudes towards the behavioural regulation of the team, which manifests in inactivity or activity to augment or merely align with protocol. These factors are not exhaustive and are contextually sensitive, but collectively implicate a significant portion of the leadership activity observed in trauma teams.

Keywords: trauma team activations, critical event management, leadership, teamwork

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Authors: Therese Besnard

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Internationally in early childhood education (ECE), the great majority of teachers are women. Some groups believe that a greater male teacher presence in ECE would be beneficial for children, specifically for boys as it could offer a positive male model. It is a common belief that children would benefit from being exposed to both male and female models. Some believe that women are naturally better suited to offer quality care to young children comparatively to men. Some authors bring forth that after equivalent training, differences in the educational practices are purely individual and do not depend on the teacher’s gender. Others believe that a greater male presence in ECE would increase the risk of pedophilia or child abuse. The few scientific studies in this area suggest that differences could exist between male and female ECE teacher, in particular when it comes to play which is the mainstay of the ECE educational program. Male teachers describe themselves as being more playful and having a greater tendency to initiate physical and turbulent play comparatively to female teachers, who describe themselves as favoring games that are calmer and focused on social interaction. Observed directly, male teachers appear more actively engaged in play with children and propose more motor play than female teachers. Furthermore children who have both male and female teachers for one year show less behavior difficulties when compared to children with only female teachers. Despite a variety of viewpoints we don’t know if the educational practices of male ECE teachers, (emotional support, classroom organization or instructional support) are different than the educational practices of female teachers and if these practices are linked with children’s adaptation. This study compares the educational practices of 37 ECE teachers (57 % male) and analyses the link with children' social adaptation (n=221). Educational practices were assessed through observational measurements with the Classroom Assessment Scoring System (CLASS) in a natural class environment. Child social adaptation was assessed with the Social Competence and Behavior Evaluation (SCBE). Observational data reveals no differences between men's and women's scale of the CLASS. Results using Multilevel models analyses suggest that the ability to propose good classroom organization and give good instructional support are linked with better child' social adaptation, and that is always true for men and women teachers. The results are discussed on the basis of their potential impact on future educational interventions.

Keywords: child social adaptation, early childhood education, educational practices, men teacher

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Authors: Wei-Po Wu, Wen-Yu Liu, Wei−Ting Lin, Hen-Yu Lien

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Introduction: Improving balance function for individuals after stroke is a crucial target in physiotherapy. Aquatic therapy which challenges individual’s postural control in an unstable fluid environment may be beneficial in enhancing balance functions. The purposes of the systematic review with meta-analyses were to validate the effects of aquatic therapy in improving balance functions for individuals with strokes in contrast to conventional physiotherapy. Method: Available studies were explored from three electronic databases: PubMed, Scopus, and Web of Science. During literature search, the published date of studies was not limited. The study design of the included studies should be randomized controlled trials (RCTs) and the studies should contain at least one outcome measurement of balance function. The PEDro scale was adopted to assess the quality of included studies, while the 'Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence' was used to evaluate the level of evidence. After the data extraction, studies with same outcome measures were pooled together for meta-analysis. Result: Ten studies with 282 participants were included in analyses. The research qualities of the studies were ranged from fair to good (4 to 8 points). Levels of evidence of the included studies were graded as level 2 and 3. Finally, scores of Berg Balance Scale (BBS), Eye closed force plate center of pressure velocity (anterior-posterior, medial-lateral axis) and Timed up and Go test were pooled and analyzed separately. The pooled results shown improvement in balance function (BBS mean difference (MD): 1.39 points; 95% confidence interval (CI): 0.05-2.29; p=0.002) (Eye closed force plate center of pressure velocity (anterior-posterior axis) MD: 1.39 mm/s; 95% confidence interval (CI): 0.93-1.86; p<0.001) (Eye closed force plate center of pressure velocity (medial-lateral) MD: 1.48 mm/s; 95% confidence interval (CI): 0.15-2.82; p=0.03) and mobility (MD: 0.9 seconds; 95% CI: 0.07-1.73; p=0.03) of stroke individuals after aquatic therapy compared to conventional therapy. Although there were significant differences between two treatment groups, the differences in improvement were relatively small. Conclusion: The aquatic therapy improved general balance function and mobility in the individuals with stroke better than conventional physiotherapy.

Keywords: aquatic therapy, balance function, meta-analysis, stroke, systematic review

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Authors: Mustafa M. Donma, Orkide Donma

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Obesity and weight gain are associated with increased risk of developing cardiovascular diseases and the progression of liver fibrosis. Aspartate transaminase–to-platelet count ratio index (AST-to-PLT, APRI) and fibrosis-4 (FIB-4) were primarily considered as the formulas capable of differentiating hepatitis from cirrhosis. Recently, they have found clinical use as measures of liver fibrosis and cardiovascular risk. However, their status in children has not been evaluated in detail yet. The aim of this study is to determine APRI and FIB-4 status in obese (OB) children and compare them with values found in children with normal body mass index (N-BMI). A total of sixty-eight children examined in the outpatient clinics of the Pediatrics Department in Tekirdag Namik Kemal University Medical Faculty were included in the study. Two groups were constituted. In the first group, thirty-five children with N-BMI, whose age- and sex-dependent BMI indices vary between 15 and 85 percentiles, were evaluated. The second group comprised thirty-three OB children whose BMI percentile values were between 95 and 99. Anthropometric measurements and routine biochemical tests were performed. Using these parameters, values for the related indices, BMI, APRI, and FIB-4, were calculated. Appropriate statistical tests were used for the evaluation of the study data. The statistical significance degree was accepted as p<0.05. In the OB group, values found for APRI and FIB-4 were higher than those calculated for the N-BMI group. However, there was no statistically significant difference between the N-BMI and OB groups in terms of APRI and FIB-4. A similar pattern was detected for triglyceride (TRG) values. The correlation coefficient and degree of significance between APRI and FIB-4 were r=0.336 and p=0.065 in the N-BMI group. On the other hand, they were r=0.707 and p=0.001 in the OB group. Associations of these two indices with TRG have shown that this parameter was strongly correlated (p<0.001) both with APRI and FIB-4 in the OB group, whereas no correlation was calculated in children with N-BMI. Triglycerides are associated with an increased risk of fatty liver, which can progress to severe clinical problems such as steatohepatitis, which can lead to liver fibrosis. Triglycerides are also independent risk factors for cardiovascular disease. In conclusion, the lack of correlation between TRG and APRI as well as FIB-4 in children with N-BMI, along with the detection of strong correlations of TRG with these indices in OB children, was the indicator of the possible onset of the tendency towards the development of fatty liver in OB children. This finding also pointed out the potential risk for cardiovascular pathologies in OB children. The nature of the difference between APRI vs FIB-4 correlations in N-BMI and OB groups (no correlation versus high correlation), respectively, may be the indicator of the importance of involving age and alanine transaminase parameters in addition to AST and PLT in the formula designed for FIB-4.

Keywords: APRI, children, FIB-4, obesity, triglycerides

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Authors: Jiyoung Lee, Andrew D. Gershoff, Jerry Jisang Han

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Most extant research on consumer privacy concerns and their willingness to share personal data has focused on contextual factors (e.g., types of information collected, type of compensation) that lead to consumers’ personal information disclosure. Unfortunately, the literature lacks a clear understanding of how consumers’ incidental psychological needs may influence consumers’ decisions to share their personal information with companies or brands. In this research, we investigate how social exclusion, which is an increasing societal problem, especially since the onset of the COVID-19 pandemic, leads to increased information disclosure intentions for consumers. Specifically, we propose and find that when consumers become socially excluded, their desire for social connection increases, and this desire leads to a greater willingness to disclose their personal information with firms. The motivation to form and maintain interpersonal relationships is one of the most fundamental human needs, and many researchers have found that deprivation of belongingness has negative consequences. Given the negative effects of social exclusion and the universal need to affiliate with others, people respond to exclusion with a motivation for social reconnection, resulting in various cognitive and behavioral consequences, such as paying greater attention to social cues and conforming to others. Here, we propose personal information disclosure as another form of behavior that can satisfy such social connection needs. As self-disclosure can serve as a strategic tool in creating and developing social relationships, those who have been socially excluded and thus have greater social connection desires may be more willing to engage in self-disclosure behavior to satisfy such needs. We conducted four experiments to test how feelings of social exclusion can influence the extent to which consumers share their personal information with brands. Various manipulations and measures were used to demonstrate the robustness of our effects. Through the four studies, we confirmed that (1) consumers who have been socially excluded show greater willingness to share their personal information with brands and that (2) such an effect is driven by the excluded individuals’ desire for social connection. Our findings shed light on how the desire for social connection arising from exclusion influences consumers’ decisions to disclose their personal information to brands. We contribute to the consumer disclosure literature by uncovering a psychological need that influences consumers’ disclosure behavior. We also extend the social exclusion literature by demonstrating that exclusion influences not only consumers’ choice of products but also their decision to disclose personal information to brands.

Keywords: consumer-brand relationship, consumer information disclosure, consumer privacy, social exclusion

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Authors: Noor Taleb Ismael, Areej Abd Al Kareem Al Titi, Ala'a Fayez Jaber

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Objectives: To investigate self-perceived functional performance among adults with IDD who are Jordanian residential care and rehabilitation centers residents. Also, to investigate their functional abilities (i.e., motor, and cognitive). In addition, to determine the motor and cognitive predictors of their functional performance. Methods: The study utilized a cross-sectional descriptive design; the sample included 180 individuals with IDD (90 males and 90 females) aged 18 to 75 years. The inclusion criteria encompassed: 1) Adults with a confirmed IDD by their physician’s professional and 2) residents in Jordanian Residential Care and Rehabilitation Centers affiliated with the Jordanian Ministry of Social Development. The exclusion criteria were: 1) bedridden or totally dependent on their care providers; 2) who had an accident or acquired neurological conditions. Researchers conducted semi-structured interviews to complete the outcome measures that include the Canadian Occupational Performance Measure (COPM), the Functional Independence Measure (FIM), the Montreal Cognitive Assessment (MoCA), the Mini-Mental Status Examination (MMSE), and the sociodemographic questionnaire. Data analyses consisted of descriptive statistics, analysis of frequencies, correlation, and regression analyses. Result: Individuals with IDD showed low functional performance in all daily life areas, including self-care, productivity, and leisure; there was severe cognitive impairment and poor independence and functional performance. (COPM Performance M= 1.433, SD±.57021, COPM Satisfaction M= 1.31, SD±.54, FIM M= 3.673, SD± 1.7918). Two predictive models were validated for the COPM performance and FIM total scores. First, significant predictors of high self-perceived functional performance on COPM were high scores on FIM Motor sub scores, FIM cognitive sub scores, young age, and having a high school educational level (R2=0.603, p=0.012). Second, significant predictors of high functional capacity on FIM were a high score on the COPM performance subscale, a high MMSE score, and having a cerebral palsy (CP) diagnosis (R2=0.671, p<0.001). Conclusions: Evaluating functional performance and associated factors is important in rehabilitation to provide better services and improve health and QoL for individuals with IDD. This study suggested conducting future studies targeting integrated individuals with IDD who live with their families in the communities.

Keywords: functional performance, intellectual and developmental disabilty, cognitive abilities, motor abilities

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Authors: Elizabeth B. Katana, Brenda N. Simbwa, Josephine Namayanja, Bob O. Amodan, Edirisa J. Nsubuga, Eva A. O. Laker

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Background: Understanding stakeholders’ perceptions towards the implementation of a mass vaccination campaign is important to ensure the design of better strategies to address challenges. We explored stakeholders’ perceptions of the implementation of a nationwide door-to-door mass vaccination campaign for the oral polio vaccine (nOPV2) in Uganda for the two rounds that occurred in January and November 2022. Methods: A qualitative study was conducted among stakeholders who participated in the campaign implementation from 8 districts in Uganda using random sampling. We conducted 46 In-depth interviews lasting 30 – 40 minutes with 6 national/central supervisors, 12 district, 14 sub-county, and 14 parish-level supervisors. Stakeholders were asked about their experiences in the campaign implementation, including challenges faced and their opinions of the campaign impact and use of the door-to-door strategy. Data were analyzed thematically in line with the major campaign activities. Results: Most of the stakeholders were primarily concerned about poor planning, inadequate training of vaccination teams, community resistance including schools, challenges with recruitment and teaming of vaccinators, poor and delayed payments, lack of logistics and motivation for vaccination teams, the timing of the activities and implementing amidst COVID-19 and Ebola. The stakeholders believed that the first round was not well planned and implemented, while the second round was leveraged in their previous experiences. On the other hand, some positive experiences were noted with regard to communication, advocacy and mobilization, vaccine delivery and distribution, district readiness assessments, and cold chain management. Conclusion: This study identified many challenges that were faced in the implementation of the door-to-door mass campaign for nOPV2 in Uganda. This study identified that more needs to be done to improve door-to-door mass campaigns with a focus on motivating the implementers. These findings highlight the need for conducting performance reviews, improved planning, especially routine updates and verification of target populations and training in microplanning, and adequate mapping of community resistance to inform the implementation of future mass campaigns.

Keywords: mass polio vaccination campaigns, door-to-door strategy, stakeholders' perceptions, implementation challenges

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Authors: N. Azouaou, H. Mokaddem, D. Senadjki, K. Kedjit, Z. Sadaoui

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Introduction: Water contamination caused by dye industries, including food, leather, textile, plastic, cosmetics, paper-making, printing and dye synthesis, has caused more and more attention, since most dyes are harmful to human being and environments. Untreated coffee grounds were used as a high-efficiency adsorbent for the removal of a cationic dye (methylene blue, MB) from aqueous solution. Characterization of the adsorbent was performed using several techniques such as SEM, surface area (BET), FTIR and pH zero charge. The effects of contact time, adsorbent dose, initial solution pH and initial concentration were systematically investigated. Results showed the adsorption kinetics followed the pseudo-second-order kinetic model. Langmuir isotherm model is in good agreement with the experimental data as compared to Freundlich and D–R models. The maximum adsorption capacity was found equal to 52.63mg/g. In addition, the possible adsorption mechanism was also proposed based on the experimental results. Experimental: The adsorption experiments were carried out in batch at room temperature. A given mass of adsorbent was added to methylene blue (MB) solution and the entirety was agitated during a certain time. The samples were carried out at quite time intervals. The concentrations of MB left in supernatant solutions after different time intervals were determined using a UV–vis spectrophotometer. The amount of MB adsorbed per unit mass of coffee grounds (qt) and the dye removal efficiency (R %) were evaluated. Results and Discussion: Some chemical and physical characteristics of coffee grounds are presented and the morphological analysis of the adsorbent was also studied. Conclusions: The good capacity of untreated coffee grounds to remove MB from aqueous solution was demonstrated in this study, highlighting its potential for effluent treatment processes. The kinetic experiments show that the adsorption is rapid and maximum adsorption capacities qmax= 52.63mg/g achieved in 30min. The adsorption process is a function of the adsorbent concentration, pH and metal ion concentration. The optimal parameters found are adsorbent dose m=5g, pH=5 and ambient temperature. FTIR spectra showed that the principal functional sites taking part in the sorption process included carboxyl and hydroxyl groups.

Keywords: adsorption, methylene blue, coffee grounds, kinetic study

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Authors: Akterono Budiyati, Gita Kusumo, Teguh Putra, Fritzie Rexana, Antonius Kurniawan, Aru Sudoyo, Ahmad Utomo, Andi Utama

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The presence of the programmed death ligand-1 (PD-L1) has been used in multiple clinical trials and approved as biomarker for selecting patients more likely to respond to immune checkpoint inhibitors. However, the expression of PD-L1 is regulated in different ways, which leads to a different significance of its presence. Positive PD-L1 within tumors may result from two mechanisms, induced PD-L1 expression by T-cell presence or genetic mechanism that lead to constitutive PD-L1 expression. Amplification of PD-L1 genes was found as one of genetic mechanism which causes an increase in PD-L1 expression. In case of colorectal cancer (CRC), targeting immune checkpoint inhibitor has been recommended for patients with microsatellite instable (MSI). Although the correlation between PD-L1 expression and MSI status has been widely studied, so far the precise mechanism of PD-L1 gene activation in CRC patients, particularly in MSI population have yet to be clarified. In this present study we have profiled 61 archived formalin fixed paraffin embedded CRC specimens of patients from Medistra Hospital, Jakarta admitted in 2010 - 2016. Immunohistochemistry was performed to measure expression of PD-L1 in tumor cells as well as MSI status using antibodies against PD-L1 and MMR (MLH1, MSH2, PMS2 and MSH6), respectively. PD-L1 expression was measured on tumor cells with cut off of 1% whereas loss of nuclear MMR protein expressions in tumor cells but not in normal or stromal cells indicated presence of MSI. Subset of PD-L1 positive patients was then assessed for copy number variations (CNVs) using single Tube TaqMan Copy Number Assays Gene CD247PD-L1. We also observed KRAS mutation to profile possible genetic mechanism leading to the presence or absence of PD-L1 expression. Analysis of 61 CRC patients revealed 15 patients (24%) expressed PD-L1 on their tumor cell membranes. The prevalence of surface membrane PD-L1 was significantly higher in patients with MSI (87%; 7/8) compared to patients with microsatellite stable (MSS) (15%; 8/53) (P=0.001). Although amplification of PD-L1 gene was not found among PD-L1 positive patients, low-level amplification of PD-L1 gene was commonly observed in MSS patients (75%; 6/8) than in MSI patients (43%; 3/7). Additionally, we found 26% of CRC patients harbored KRAS mutations (16/61), so far the distribution of KRAS status did not correlate with PD-L1 expression. Our data suggest genetic mechanism through amplification of PD-L1 seems not to be the mechanism underlying upregulation of PD-L1 expression in CRC patients. However, further studies are warranted to confirm the results.

Keywords: colorectal cancer, gene amplification, microsatellite instable, programmed death ligand-1

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Authors: Tegene Nigussie

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Introduction: Maize is the most domesticated of all the field crops. Wild maize has not been found to date and there has been much speculation on its origin. Regardless of the validity of different theories, it is generally agreed that the center of origin of maize is Central America, primarily Mexico and the Caribbean. Maize in Africa is of a recent introduction although data suggest that it was present in Nigeria even before Columbus voyages. After being taken to Europe in 1493, maize was introduced to Africa and distributed (spread through the continent by different routes. Maize is an important cereal crop in Ethiopia in general, it is the primarily stable food, and rural households show strong preference. For human food, the important constituents of grain are carbohydrates (starch and sugars), protein, fat or oil (in the embryo) and minerals. About 75 percent of the kernel is starch, a range of 60.80 percent but low protein content (8-15%). In Ethiopia, the introduction of modern farming techniques appears to be a priority. However, the adoption of modern inputs by peasant farmers is found to be very slow, for example, the adoption rate of fertilizer, an input that is relatively adopted, is very slow. The difference in socio-economic factors lay behind the low rate of technological adoption, including price & marketing input. Objective: The aim of the study is to determine the optimum application rate or level of different phosphorus fertilizers for the vegetative growth of maize and to identify the effect of different phosphorus rates on the growth and development of maize. Methods: The vegetative parameter (above ground) measurement from five plants randomly sampled from the middle rows of each plot. Results: The interaction of nitrogen and maize variety showed a significant at (p<0.01) effect on plant height, with the application of 60kg/ha and BH140 maize variety in combination and root length with the application of 60kg/ha of nitrogen and BH140 variety of maize. The highest mean (12.33) of the number of leaves per plant and mean (7.1) of the number of nodes per plant can be used as an alternative for better vegetative growth of maize. Conclusion and Recommendation: Maize is one of the popular and cultivated crops in Ethiopia. This study was conducted to investigate the best dosage of phosphorus for vegetative growth, yield, and better quality of maize variety and to recommend a level of phosphorus rate and the best variety adaptable to the specific soil condition or area.

Keywords: leaf, carbohydrate protein, adoption, sugar

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Authors: Diriba T. Balcha, Boris Kulig, Oliver Hensel, Eyassu Woldesenbet

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Enset fiber is agricultural waste and available in a surplus amount in Ethiopia. However, the hypothesized variation in properties of this fiber due to diversity of its plant source breed, fiber position within plant stem and chemical treatment duration had not proven that its application for the development of composite products is problematic. Currently, limited data are known on the functional properties of the fiber as a potential functional fiber. Thus, an effort is made in this study to narrow the knowledge gaps by characterizing it. The experimental design was conducted using Design-Expert software and the tensile test was conducted on Enset fiber from 10 breeds: Dego, Dirbo, Gishera, Itine, Siskela, Neciho, Yesherkinke, Tuzuma, Ankogena, and Kucharkia. The effects of 5% Na-OH surface treatment duration and fiber location along and across the plant pseudostem was also investigated. The test result shows that the rupture stress variation is not significant among the fibers from 10 Enset breeds. However, strain variation is significant among the fibers from 10 Enset breeds that breed Dego fiber has the highest strain before failure. Surface treated fibers showed improved rupture strength and elastic modulus per 24 hours of treatment duration. Also, the result showed that chemical treatment can deteriorate the load-bearing capacity of the fiber. The raw fiber has the higher load-bearing capacity than the treated fiber. And, it was noted that both the rupture stress and strain increase in the top to bottom gradient, whereas there is no significant variation across the stem. Elastic modulus variation both along and across the stem was insignificant. The rupture stress, elastic modulus, and strain result of Enset fiber are 360.11 ± 181.86 MPa, 12.80 ± 6.85 GPa and 0.04 ± 0.02 mm/mm, respectively. These results show that Enset fiber is comparable to other natural fibers such as abaca, banana, and sisal fibers and can be used as alternatives natural fiber for composites application. Besides, the insignificant variation of properties among breeds and across stem is essential for all breeds and all leaf sheath of the Enset fiber plant for fiber extraction. The use of short natural fiber over the long is preferable to reduce the significant variation of properties along the stem or fiber direction. In conclusion, Enset fiber application for composite product design and development is mechanically feasible.

Keywords: Agricultural waste, Chemical treatment, Fiber characteristics, Natural fiber

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Authors: Nivedita Paul

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The changing character of marriage be it arranged marriage, love marriage, polygamy, informal unions, all signify different gender relations in everyday lives. Marriages in India are part and parcel of the kinship and cultural practices. Arranged marriage is still the dominant form of marriage where spouse selection is the initiative and decision of the parents; but its form is changing, as women are now actively participating in spouse selection but with parental consent. Spouse selection related decision making is important because marriage as an institution brings social change and gender inequality; especially in a women’s life as marriages in India are mostly patrilocal. Moreover, the amount of say in spouse selection can affect a woman’s reproductive rights, domestic violence issues, household resource allocation, communication possibilities with the spouse/husband, marital life, etc. The present study uses data from Indian Human Development Survey II (2011-12) which is a nationally representative multitopic survey that covers 41,554 households. Currently, married women of age group 15-49 in their first marriage; whose year of marriage is from 1970s to 2000s have been taken for the study. Based on spouse selection experiences, the sample of women has been divided into three marriage categories-self, semi and family arranged. Women in self arranged or love marriage is the sole decision maker in choosing the partner, in semi arranged marriage or arranged marriage with consent both parents and women together take the decision, whereas in family arranged or arranged marriage without consent only parents take the decision. The main aim of the study is to find the relationship between spouse selection experiences and women’s autonomy in India. Decision making in economic matters, child and health related decision making, mobility and access to resources are taken to be proxies of autonomy. Method of ordinal regression has been used to find the relationship between spouse selection experiences and autonomy after marriage keeping other independent variables as control factors. Results show that women in semi arranged marriage have more decision making power regarding financial matters of the household, health related matters, mobility and accessibility to resources, when compared to women in family, arranged marriages. For freedom of movement and access to resources women in self arranged marriage have the highest say or exercise greatest power. Therefore, greater participation of women (even though not absolute control) in spouse selection may lead to greater autonomy after marriage.

Keywords: arranged marriage, autonomy, consent, spouse selection

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Authors: Mdluli Fezile, Schmidt Stefan, Thamaga-Chitja Joyce

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In view of the frequently reported foodborne disease outbreaks caused by contaminated fresh produce, consumers have a preference for foods that meet requisite hygiene standards to reduce the risk of foodborne illnesses. Producing good quality fresh produce then becomes critical in improving market access and food security, especially for small-scale farmers. Questions of hygiene and subsequent microbiological quality in the rural small-scale farming sector of South Africa are even more crucial, given the policy drive to develop small-scale farming as a measure for reinforcement of household food security and reduction of poverty. Farming practices and methods, throughout the fresh produce value chain, influence the quality of the final product, which in turn determines its success in the market. This study’s aim was to therefore determine the extent to which training on organic farming methods, including modules such as Importance of Production Hygiene, influenced the hygienic farming practices employed by eTholeni small-scale organic farmers in uMbumbulu, KwaZulu-Natal- South Africa. Questionnaires were administered to 73 uncertified organic farmers and analysis showed that a total of 33 farmers were trained and supplied the local Agri-Hub while 40 had not received training. The questionnaire probed respondents’ attitudes, knowledge of hygiene and composting practices. Data analysis included descriptive statistics such as the Chi-square test and a logistic regression model. Descriptive analysis indicated that a majority of the farmers (60%) were female, most of which (73%) were above the age of 40. The logistic regression indicated that factors such as farmer training and prior experience in the farming sector had a significant influence on hygiene practices both at 5% significance levels. These results emphasize the importance of training, education and farming experience in implementing good hygiene practices in small-scale farming. It is therefore recommended that South African policies should advocate for small-scale farmer training, not only for subsistence purposes, but also with an aim of supplying produce markets with high fresh produce.

Keywords: small-scale farmers, leafy salad vegetables, organic produce, food safety, hygienic practices, food security

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Authors: Arefeh Arabaninezhad, Ali Fakher

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Since the deterministic analysis methods fail to take system uncertainties into account, probabilistic and non-probabilistic methods are suggested. Geotechnical analyses are used to determine the stress and deformation caused by construction; accordingly, many input variables which depend on ground behavior are required for geotechnical analyses. The Random Set approach is an applicable reliability analysis method when comprehensive sources of information are not available. Using Random Set method, with relatively small number of simulations compared to fully probabilistic methods, smooth extremes on system responses are obtained. Therefore random set approach has been proposed for reliability analysis in geotechnical problems. In the present study, the application of random set method in reliability analysis of deep excavations is investigated through three deep excavation projects which were monitored during the excavating process. A finite element code is utilized for numerical modeling. Two expected ranges, from different sources of information, are established for each input variable, and a specific probability assignment is defined for each range. To determine the most influential input variables and subsequently reducing the number of required finite element calculations, sensitivity analysis is carried out. Input data for finite element model are obtained by combining the upper and lower bounds of the input variables. The relevant probability share of each finite element calculation is determined considering the probability assigned to input variables present in these combinations. Horizontal displacement of the top point of excavation is considered as the main response of the system. The result of reliability analysis for each intended deep excavation is presented by constructing the Belief and Plausibility distribution function (i.e. lower and upper bounds) of system response obtained from deterministic finite element calculations. To evaluate the quality of input variables as well as applied reliability analysis method, the range of displacements extracted from models has been compared to the in situ measurements and good agreement is observed. The comparison also showed that Random Set Finite Element Method applies to estimate the horizontal displacement of the top point of deep excavation. Finally, the probability of failure or unsatisfactory performance of the system is evaluated by comparing the threshold displacement with reliability analysis results.

Keywords: deep excavation, random set finite element method, reliability analysis, uncertainty

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Authors: Samuele Abagnato, Lucia Rigamonti

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Life-Cycle-Assessment (LCA) is an effective tool to quantify the environmental impacts of reuse models and recycling technologies for textiles. In this work, publications in the last ten years about LCA on textile waste are classified according to location, goal and scope, functional unit, waste composition, impact assessment method, impact categories, and sensitivity analysis. Twenty papers have been selected: 50% are focused only on recycling, 30% only on reuse, the 15% on both, while only one paper considers only the final disposal of the waste. It is found that reuse is generally the best way to decrease the environmental impacts of textiles waste management because of the avoided impacts of manufacturing a new item. In the comparison between a product made with recycled yarns and a product from virgin materials, in general, the first option is less impact, especially for the categories of climate change, water depletion, and land occupation, while for other categories, such as eutrophication or ecotoxicity, under certain conditions the impacts of the recycled fibres can be higher. Cultivation seems to have quite high impacts when natural fibres are involved, especially in the land use and water depletion categories, while manufacturing requires a remarkable amount of electricity, with its associated impact on climate change. In the analysis of the reuse processes, relevant importance is covered by the laundry phase, with water consumption and impacts related to the use of detergents. About the sensitivity analysis, it can be stated that one of the main variables that influence the LCA results and that needs to be further investigated in the modeling of the LCA system about this topic is the substitution rate between recycled and virgin fibres, that is the amount of recycled material that can be used in place of virgin one. Related to this, also the yield of the recycling processes has a strong influence on the results of the impact. The substitution rate is also important in the modeling of the reuse processes because it represents the number of avoided new items bought in place of the reused ones. Another aspect that appears to have a large influence on the impacts is consumer behaviour during the use phase (for example, the number of uses between two laundry cycles). In conclusion, to have a deeper knowledge of the impacts of a life-cycle approach of textile waste, further data and research are needed in the modeling of the substitution rate and of the use phase habits of the consumers.

Keywords: environmental impacts, life-cycle-assessment, textiles recycling, textiles reuse, textiles waste management

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Authors: Sahar Elsaleh, Ghada Farhat, Shaikha Al-Derham, Fasih Alam

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Background: Cesarean section (CS) delivery is one of the major concerns both in developing and developed countries. The rate of CS deliveries are on the rise globally, and especially in Qatar. Many socio-economic, demographic, clinical and institutional factors play an important role for cesarean sections. This study aims to investigate factors affecting the prevalence of CS among women in Qatar using the UNICEF’s Multiple Indicator Cluster Survey (MICS) 2012 database. Methods: The study has focused on the women’s questionnaire of the MICS, which was successfully distributed to 5699 participants. Following study inclusion and exclusion criteria, a final sample of 761 women aged 19- 49 years who had at least one delivery of giving birth in their lifetime before the survey were included. A number of socio-economic, demographic, clinical and institutional factors, identified through literature review and available in the data, were considered for the analyses. Bivariate and multivariate logistic regression models, along with a multi-level modeling to investigate clustering effect, were undertaken to identify the factors that affect CS prevalence in Qatar. Results: From the bivariate analyses the study has shown that, a number of categorical factors are statistically significantly associated with the dependent variable (CS). When identifying the factors from a multivariate logistic regression, the study found that only three categorical factors -‘age of women’, ‘place at delivery’ and ‘baby weight’ appeared to be significantly affecting the CS among women in Qatar. Although the MICS dataset is based on a cluster survey, an exploratory multi-level analysis did not show any clustering effect, i.e. no significant variation in results at higher level (households), suggesting that all analyses at lower level (individual respondent) are valid without any significant bias in results. Conclusion: The study found a statistically significant association between the dependent variable (CS delivery) and age of women, frequency of TV watching, assistance at birth and place of birth. These results need to be interpreted cautiously; however, it can be used as evidence-base for further research on cesarean section delivery in Qatar.

Keywords: cesarean section, factors, multiple indicator cluster survey, MICS database, Qatar

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Authors: Sugene Kim

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The English articles are taught as a binary system based on nominal countability and definiteness. Despite the detailed rules of prescriptive grammar, it has been consistently reported in the literature that their correct usage is extremely difficult to master even for advanced learners of English as a second language (ESL) or a foreign language (EFL). Given that an English sentence (except for an imperative) cannot be constructed without a noun, which is always paired with one of the indefinite, definite, and zero articles; it is essential to understand specifically what causes ESL/EFL learners to misuse them. To that end, this study examined EFL learners’ article use employing a one-group pre–post-test design. Forty-three Korean college students received instruction on correct English article usage for two 75-minute classes employing the binary schema set up for the study. They also practiced in class how to apply the rules as instructed. Then, the participants were assigned a forced-choice elicitation task, which was also used as a pre-test administered three months prior to the instruction. Unlike the pre-test on which they only chose the correct article for each of the 40 items, the post-instruction task additionally asked them to give written accounts of their decision-making procedure to choose the article as they did. The participants’ performance was scored manually by checking whether the answer given is correct or incorrect, and their written comments were first categorized using thematic analysis and then ranked by frequency. The analyses of the performance on the two tasks and the written think-aloud data suggested that EFL learners exhibit fluctuation between specificity and definiteness, overgeneralizing the use of the definite article for almost all cataphoric references. It was apparent that they have trouble distinguishing from the two concepts possibly because the former is almost never introduced in the grammar books or classes designed for ESL/EFL learners. Particularly, most participants were found to be ignorant of the possibility of using nouns as [+specific, –definite]. Not surprisingly, the correct answer rates for such nouns averaged out at 33% and 46% on the pre- and post-tests, respectively, which narrowly reach half the overall mean correct answer rates of 65% on the pre-test and 81% on the post-test. In addition, correct article use for specific indefinites was most impermeable to instruction when compared with nouns used as [–specific, –definite] or [± specific, +definite]. Such findings underline the necessity for expanding the binary schema to a ternary form that incorporates the specificity feature, albeit not morphologically marked in the English language.

Keywords: countability, definiteness, English articles, specificity, ternary system

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Authors: Mustafa M. Donma, Orkide Donma

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Pediatric overweight and obesity need attention because they may cause morbid obesity, which may develop metabolic syndrome (MetS). Criteria used for the definition of adult MetS cannot be applied for pediatric MetS. Dynamic physiological changes that occur during childhood and adolescence require the evaluation of each parameter based upon age intervals. The aim of this study is to investigate the distribution of blood pressure (BP) values within diverse pediatric age intervals and the possible use and clinical utility of a recently introduced Diagnostic Obesity Notation Model Assessment Tension (DONMA tense) Index derived from systolic BP (SBP) and diastolic BP (DBP) [SBP+DBP/200]. Such a formula may enable a more integrative picture for the assessment of pediatric obesity and MetS due to the use of both SBP and DBP. 554 children, whose ages were between 6-16 years participated in the study; the study population was divided into two groups based upon their ages. The first group comprises 280 cases aged 6-10 years (72-120 months), while those aged 10-16 years (121-192 months) constituted the second group. The values of SBP, DBP and the formula (SBP+DBP/200) covering both were evaluated. Each group was divided into seven subgroups with varying degrees of obesity and MetS criteria. Two clinical definitions of MetS have been described. These groups were MetS3 (children with three major components), and MetS2 (children with two major components). The other groups were morbid obese (MO), obese (OB), overweight (OW), normal (N) and underweight (UW). The children were included into the groups according to the age- and sex-based body mass index (BMI) percentile values tabulated by WHO. Data were evaluated by SPSS version 16 with p < 0.05 as the statistical significance degree. Tension index was evaluated in the groups above and below 10 years of age. This index differed significantly between N and MetS as well as OW and MetS groups (p = 0.001) above 120 months. However, below 120 months, significant differences existed between MetS3 and MetS2 (p = 0.003) as well as MetS3 and MO (p = 0.001). In comparison with the SBP and DBP values, tension index values have enabled more clear-cut separation between the groups. It has been detected that the tension index was capable of discriminating MetS3 from MetS2 in the group, which was composed of children aged 6-10 years. This was not possible in the older group of children. This index was more informative for the first group. This study also confirmed that 130 mm Hg and 85 mm Hg cut-off points for SBP and DBP, respectively, are too high for serving as MetS criteria in children because the mean value for tension index was calculated as 1.00 among MetS children. This finding has shown that much lower cut-off points must be set for SBP and DBP for the diagnosis of pediatric MetS, especially for children under-10 years of age. This index may be recommended to discriminate MO, MetS2 and MetS3 among the 6-10 years of age group, whose MetS diagnosis is problematic.

Keywords: blood pressure, children, index, metabolic syndrome, obesity

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Authors: Christos Karolemeas, Avgi Vassi, Georgia Christodoulopoulou

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Although the past decades, planning a cycle network became an inseparable part of all transportation plans, there is still a lot of room for improvement in the way planning is made, in order to create safe and direct cycling networks that gather the parameters that positively influence one's decision to cycle. The aim of this article is to study, evaluate and visualize the bikeability of cities. This term is often used as the 'the ability of a person to bike' but this study, however, adopts the term in the sense of bikeability as 'the ability of the urban landscape to be biked'. The methodology used included assessing cities' accessibility by cycling, based on international literature and corresponding walkability methods and the creation of a 'bikeability index'. Initially, a literature review was made to identify the factors that positively affect the use of bicycle infrastructure. Those factors were used in order to create the spatial index and quantitatively compare the city network. Finally, the bikeability index was applied in two case studies: two Greek municipalities that, although, they have similarities in terms of land uses, population density and traffic congestion, they are totally different in terms of geomorphology. The factors suggested by international literature were (a) safety, (b) directness, (c) comfort and (d) the quality of the urban environment. Those factors were quantified through the following parameters: slope, junction density, traffic density, traffic speed, natural environment, built environment, activities coverage, centrality and accessibility to public transport stations. Each road section was graded for the above-mentioned parameters, and the overall grade shows the level of bicycle accessibility (low, medium, high). Each parameter, as well as the overall accessibility levels, were analyzed and visualized through Geographic Information Systems. This paper presents the bikeability index, its' results, the problems that have arisen and the conclusions from its' implementation through Strengths-Weaknesses-Opportunities-Threats analysis. The purpose of this index is to make it easy for researchers, practitioners, politicians, and stakeholders to quantify, visualize and understand which parts of the urban fabric are suitable for cycling.

Keywords: accessibility, cycling, green spaces, spatial data, urban environment

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Authors: Sabrina N. Rabelo, Tiago de F. Paulino, Willian M. Duarte, Samer Sawalha, Luiz Machado

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Energy use is one of the main indicators for the economic and social development of a country, reflecting directly in the quality of life of the population. The expansion of energy use together with the depletion of fossil resources and the poor efficiency of energy systems have led many countries in recent years to invest in renewable energy sources. In this context, solar-assisted heat pump has become very important in energy industry, since it can transfer heat energy from the sun to water or another absorbing source. The direct-expansion solar assisted heat pump (DX-SAHP) water heater system operates by receiving solar energy incident in a solar collector, which serves as an evaporator in a refrigeration cycle, and the energy reject by the condenser is used for water heating. In this paper, a DX-SAHP using carbon dioxide as refrigerant (R744) was assembled, and the influence of the variation of the water mass flow rate in the system was analyzed. The parameters such as high pressure, water outlet temperature, gas cooler outlet temperature, evaporator temperature, and the coefficient of performance were studied. The mainly components used to assemble the heat pump were a reciprocating compressor, a gas cooler which is a countercurrent concentric tube heat exchanger, a needle-valve, and an evaporator that is a copper bare flat plate solar collector designed to capture direct and diffuse radiation. Routines were developed in the LabVIEW and CoolProp through MATLAB software’s, respectively, to collect data and calculate the thermodynamics properties. The range of coefficient of performance measured was from 3.2 to 5.34. It was noticed that, with the higher water mass flow rate, the water outlet temperature decreased, and consequently, the coefficient of performance of the system increases since the heat transfer in the gas cooler is higher. In addition, the high pressure of the system and the CO₂ gas cooler outlet temperature decreased. The heat pump using carbon dioxide as a refrigerant, especially operating with solar radiation has been proven to be a renewable source in an efficient system for heating residential water compared to electrical heaters reaching temperatures between 40 °C and 80 °C.

Keywords: water mass flow rate, R-744, heat pump, solar evaporator, water heater

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Authors: Rizalito B. Javier

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Research has shown that foreign students with higher levels of cultural awareness and intercultural communication competence tend to have better academic performance outcomes. This study aimed to find out the cultural awareness, intercultural communication competence, and academic performance of foreign students and its relationships among variables. Methods used were descriptive-comparative and correlational research design, quota purposive sampling technique while frequency counts and percentages, mean and standard deviation, T, and F-test and chi-square were utilized to analyze the data. The results revealed that the majority of the respondents were under the age bracket of 21-25 years old, mostly males, all single, and mostly citizens of Papua New Guinea, Angolan, Vanuatu, Tanzanian, Nigerian, Korean, Rwanda, and Myanmar. Most language spoken was English, many of them were born again Christians, the majority took BS business management degree program, their studies mainly supported by their parents, they had stayed in the Philippines for 3-4 years, and most of them attended five to six times of cultural awareness/competence workshop-seminars, majority of their parent’s occupations were family own business, and had been earning a family monthly income of P61,0000 and above. The respondents were highly aware of their culture in terms of clients’ issues. The intercultural communication competence of the respondents was slightly aware in terms of intercultural awareness, while the foreign students performed good remarks in their average academic performance. However, the profiles of the participants in terms of age, gender, civil status, nationality, course/degree program taken, support to the study, length of stay, workshop attended, and parents’ occupation have significant differences in the academic performance except for the type of family, language spoken, religion and family monthly income. Moreover, cultural awareness was significantly related to intercultural communication competence, and both were not related to academic performance. It is recommended that foreign students be provided with cultural orientation programs, offered language support services, promoted intercultural exchange activities, and implemented inclusive teaching practices to allow students to effectively navigate and interact with people from different cultural backgrounds, fostering a more inclusive and collaborative learning environment.

Keywords: cultural competence, communication competence, intercultural competence, and culture-academic performance.

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